Characterization of central venous catheter-associated deep venous thrombosis in infants

Brian W. Gray, Raquel Gonzalez, Kavita S. Warrier, Lauren A. Stephens, Robert A. Drongowski, Steven W. Pipe, George B. Mychaliska

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Deep venous thrombosis (DVT) is a frequent complication in infants with central venous catheters (CVCs). We performed this study to identify risk factors and risk-reduction strategies of CVC-associated DVT in infants. Methods: Infants younger than 1 year who had a CVC placed at our center from 2005 to 2009 were reviewed. Patients with ultrasonically diagnosed DVT were compared to those without radiographic evidence. Results: Of 333 patients, 47% (155/333) had femoral, 33% (111/333) had jugular, and 19% (64/333) had subclavian CVCs. Deep venous thromboses occurred in 18% (60/333) of patients. Sixty percent (36/60) of DVTs were in femoral veins. Femoral CVCs were associated with greater DVT rates (27%; 42/155) than jugular (11%; 12/111) or subclavian CVCs (9%; 6/64; P < .01). There was a 16% DVT rate in those with saphenofemoral Broviac CVCs vs 83% (20/24) in those with percutaneous femoral lines (P < .01). Multilumen CVCs had higher DVT rates than did single-lumen CVCs (54% vs 6%, P < .01), and mean catheter days before DVT diagnosis was shorter for percutaneous lines than Broviacs (13 ± 17 days vs 30 ± 37 days, P = .02). Patients with +DVT had longer length of stay (86 ± 88 days vs 48 ± 48 days, P < .01) and higher percentage of intensive care unit admission (82% vs 70%, P = .02). Conclusions: Deep venous thrombosis reduction strategies in infants with CVCs include avoiding percutaneous femoral and multilumen CVCs, screening percutaneous lines, and early catheter removal.

Original languageEnglish (US)
Pages (from-to)1159-1166
Number of pages8
JournalJournal of pediatric surgery
Volume47
Issue number6
DOIs
StatePublished - Jun 2012
Externally publishedYes

Keywords

  • Central venous catheter
  • DVT
  • Deep venous thrombosis
  • Infant

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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