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Identification of a "VTE-rich" population in pediatrics - Critically ill children with central venous catheters

Minh Tran1, Steven L Shein2, Xinge Ji3

  • 1UH Rainbow Babies and Children's Hospital, Pediatric Critical Care, Cleveland, OH, USA; Willis-Knighton Health System, Pediatric Critical Care, Shreveport, LA, USA.

Thrombosis Research
|December 6, 2017
PubMed

Insights

Venous thromboembolism (VTE) is increasingly diagnosed in pediatric intensive care unit (PICU) patients with central venous catheters (CVCs). Identifying high-risk children with VTE is crucial for targeted prevention strategies.

Area of Science:

  • Pediatric critical care medicine
  • Hematology
  • Clinical epidemiology

Background:

  • Rising incidence of venous thromboembolism (VTE) in US hospital inpatients.
  • Particular concern for children with central venous catheters (CVCs) in the pediatric intensive care unit (PICU).

Purpose of the Study:

  • Identify a
  • VTE-rich
  • subpopulation among PICU children with CVCs.
  • Assess the impact of VTE on morbidity and mortality in this group.

Main Methods:

  • Extracted data from the multicenter Virtual PICU Database (VPS).
  • Included children with CVC and VTE.
  • Analyzed all-cause mortality and prolonged mechanical ventilation as primary and secondary outcomes.

Main Results:

  • Identified 1602 VTE cases (103 per 10,000 PICU patients) among 158,299 CVC patients.
  • Increased VTE risk associated with age <1 year, mechanical ventilation, cardiac catheterization, and specific CVC types (PICC, percutaneous).
  • VTE in PICU patients with CVCs correlated with higher mortality and reduced ventilator-free days.

Conclusions:

  • Critically ill children with CVCs face significant VTE risk.
  • Identifying high-risk populations can inform clinical trials for VTE prevention in hospitalized PICU children.
Abstract

Keywords:
Central venous cathetersCritical carePediatricsRisk factorsVenous thromboembolism

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