| Autor: |
Sol JJ; Department of Pediatrics, Groene Hart Hospital, Gouda †Pediatric Intensive Care Unit Departments of ‡Pediatric Radiology ∥Pediatric Hematology, Emma Children's Hospital/AMC, Amsterdam §Intensive Care Unit, Red Cross Hospital, Beverwijk, The Netherlands., Knoester H, de Neef M, Smets AM, Betlem A, van Ommen CH |
| Jazyk: |
angličtina |
| Zdroj: |
Journal of pediatric hematology/oncology [J Pediatr Hematol Oncol] 2015 Aug; Vol. 37 (6), pp. 462-7. |
| DOI: |
10.1097/MPH.0000000000000370 |
| Abstrakt: |
Prescription of thromboprophylaxis is not a common practice in pediatric intensive care units. Most thrombi are catheter-related and asymptomatic, without causing acute complications. However, chronic complications of these (a)symptomatic catheter-related thrombi, that is, postthrombotic syndrome (PTS) and residual thrombosis have not been studied. To investigate these complications, critically ill children of 1 tertiary center with percutaneous inserted femoral central venous catheters (FCVCs) were prospectively followed. Symptomatic FCVC-thrombosis occurred in 10 of the 134 children (7.5%; 95% confidence interval [CI], 2.4-9.5). Only FCVC-infection appeared to be independently associated (P=0.001) with FCVC-thrombosis. At follow-up 2 of the 5 survivors diagnosed with symptomatic thrombosis developed mild PTS; one of them had an occluded vein on ultrasonography. A survivor without PTS had a partial occluded vein at follow-up. Asymptomatic FCVC-thrombosis occurred in 3 of the 42 children (7.1%; 95% CI, 0.0-16.7) screened by ultrasonography within 72 hours after catheter removal. At follow-up, mild PTS was present in 6 of the 33 (18.2%; 95% CI, 6.1-30.3) screened children. Partial and total vein occlusion was present in 1 (3%) and 4 (12%) children, respectively. In conclusion, children on pediatric intensive care units are at risk for (a)symptomatic FCVC-thrombosis, especially children with FCVC-infection. Chronic complications of FCVC-thrombosis are common. Therefore, thromboprophylaxis guidelines are warranted in pediatric intensive care units to minimize morbidity as a result of FCVC-thrombosis. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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