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Central venous catheter-related thrombosis in pediatric surgical patients: A prospective observational study

Eun-Hee Kim1, Ji-Hyun Lee1, Hee-Soo Kim1

  • 1Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.

Paediatric Anaesthesia
|November 29, 2021
PubMed

Insights

Catheter-related thrombosis in pediatric internal jugular veins is common, affecting 38.8% of patients. Multiple insertion attempts significantly increase thrombosis risk, highlighting a key factor for prevention.

Area of Science:

  • Vascular Surgery
  • Pediatric Anesthesiology
  • Diagnostic Ultrasound

Background:

  • Central venous catheters are essential in perioperative care for pediatric surgical patients.
  • Catheterization carries risks, including venous thrombosis, which can lead to complications.

Purpose of the Study:

  • To determine the incidence of internal jugular vein thrombosis (IJVТ) in pediatric surgical patients following central venous catheterization.
  • To identify perioperative risk factors associated with catheter-related thrombosis.

Main Methods:

  • Prospective observational study involving pediatric patients (<6 years) undergoing right internal jugular vein catheterization.
  • Real-time ultrasound guidance for catheter insertion and serial ultrasonographic examinations for thrombosis detection.
  • Primary endpoint: incidence of IJVТ from insertion to postoperative day 5 or catheter removal; Secondary endpoint: risk factor analysis.

Main Results:

  • Internal jugular vein thrombi detected in 31 of 80 patients (38.8%).
  • The number of insertion attempts was the sole significant predictor of thrombosis (p < .001).
  • Increased risk of thrombosis with >2 insertion attempts (OR 5.6). Longer anesthesia time, red blood cell transfusion, and ICU stay were associated with persistent thrombosis.

Conclusions:

  • Internal jugular vein thrombosis is frequently observed post-central venous catheterization in pediatric surgical patients.
  • Multiple catheter insertion attempts are a significant risk factor for developing thrombosis.
  • The clinical significance of ultrasound-detected thrombi requires further investigation.
Abstract

Keywords:
Internal jugular vein thrombosiscentral venous catheterizationincidencepediatricperioperative risk factors

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