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A prospective study of femoral catheter-related thrombosis in children
G A Talbott1, W D Winters, S L Bratton
1Department of Anesthesiology, University of Washington School of Medicine, Seattle.
Objectives:
To establish the incidence and correlate clinical findings of femoral venous catheter-related thrombus formation in critically ill children.
Research Design:
Observational prospective blinded study.
Setting:
University-affiliated pediatric hospital intensive care unit.
Patients:
Twenty children admitted to the pediatric intensive care unit who had percutaneous femoral venous catheters placed while in the pediatric intensive care unit.
Interventions:
None.
Measurements:
Duplex Doppler ultrasonography evaluation of femoral vein catheters at 1 to 2, 3 to 5, and 7 to 10 days after placement was used to detect the presence of thrombus formation and venous occlusion. Demographic patient data, pediatric risk of mortality scores, and clinical findings, including leg swelling and whether catheters would aspirate blood, were also recorded. Continuous data were analyzed using the Mann-Whitney U Test, and categorical data were compared with Fisher's Exact Test. Statistical significance was assigned at a P value of .05 or less.
Conclusions:
The overall incidence of catheter-related femoral vein thrombus formation was 35% (7/20). Ipsilateral leg swelling and the inability to aspirate blood from the catheter were significantly associated with thrombus formation. Patients who developed thrombi were younger and smaller than those who did not. In six of seven patients, thrombus formation was clinically occult when first demonstrated by ultrasonography.