Hospital-Acquired Venous Thromboembolism and Invasive Mechanical Ventilation: A Report From the Children's Hospital Acquired Thrombosis Consortium.

Autor:	Sochet AA; Department of Medicine, Divisions of Critical Care Medicine, Johns Hopkins All Children's Hospital, St. Petersburg, FL.; Institute for Clinical and Translational Research, Johns Hopkins All Children's Hospital, St. Petersburg, FL.; Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.; Department of Pediatrics, Division of Hematology/Oncology, Rady Children's Hospital, San Diego, CA.; Division of Hematology, Oncology, and Bone Marrow Transplant, Medical College of Wisconsin, Milwaukee, WI.; Versiti Medical Sciences Institute, Milwaukee, WI.; Department of Pediatrics, University of South Florida Morsani College of Medicine, Tampa, FL.; Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD.; Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD.; Department of Pediatrics, Yale School of Medicine, New Haven, CT.; Cancer and Blood Disorders Institute, Division of Hematology, Johns Hopkins All Children's Hospital, St. Petersburg, FL.; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD., Jaffray J; Department of Pediatrics, Division of Hematology/Oncology, Rady Children's Hospital, San Diego, CA., Branchford BR; Division of Hematology, Oncology, and Bone Marrow Transplant, Medical College of Wisconsin, Milwaukee, WI.; Versiti Medical Sciences Institute, Milwaukee, WI., Havlicek EE; Department of Pediatrics, University of South Florida Morsani College of Medicine, Tampa, FL., Mosha M; Institute for Clinical and Translational Research, Johns Hopkins All Children's Hospital, St. Petersburg, FL., Amankwah EK; Institute for Clinical and Translational Research, Johns Hopkins All Children's Hospital, St. Petersburg, FL.; Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD.; Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD., Ignjatovic V; Institute for Clinical and Translational Research, Johns Hopkins All Children's Hospital, St. Petersburg, FL.; Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD., Faustino EVS; Department of Pediatrics, Yale School of Medicine, New Haven, CT., Goldenberg NA; Institute for Clinical and Translational Research, Johns Hopkins All Children's Hospital, St. Petersburg, FL.; Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD.; Cancer and Blood Disorders Institute, Division of Hematology, Johns Hopkins All Children's Hospital, St. Petersburg, FL.; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Jazyk:	angličtina
Zdroj:	Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies [Pediatr Crit Care Med] 2024 Feb 01; Vol. 25 (2), pp. e82-e90. Date of Electronic Publication: 2023 Oct 26.
DOI:	10.1097/PCC.0000000000003383
Abstrakt:	Objectives: To determine if the duration of invasive mechanical ventilation (IMV) was associated with hospital-acquired venous thromboembolism (HA-VTE) among critically ill children. Design: A multicenter, matched case-control study as a secondary analysis of Children's Hospital Acquired Thrombosis (CHAT) Consortium registry. Setting: PICUs within U.S. CHAT Consortium participating centers. Patients: Children younger than 21 years old admitted to a PICU receiving IMV for greater than or equal to 1 day duration from January 2012 to March 2022 were included for study. Cases with HA-VTE were matched 1:2 to controls without HA-VTE by patient age groups: younger than 1, 1-12, and older than 12 years. Interventions: None. Measurements and Main Results: The primary outcome was IMV duration in days. Descriptive data included demographics, anthropometrics, HA-VTE characteristics (i.e., type, location, and timing), central venous catheterization data, thromboprophylaxis practices, and Braden Q mobility scores. Descriptive, comparative, and associative (multivariate conditional logistic regression for HA-VTE) statistics were employed. A total of 152 cases were matched to 304 controls. Cases with HA-VTE were diagnosed at a median of 7 days (interquartile range [IQR], 3-16 d) after IMV. The HA-VTE were limb deep venous thromboses in 130 of 152 (85.5%) and frequently central venous catheterization-related (111/152, 73%). Cases with HA-VTE experienced a longer length of stay (median, 34 d [IQR, 18-62 d] vs. 11.5 d [IQR, 6-21 d]; p < 0.001) and IMV duration (median, 7 d [IQR, 4-15 d] vs. 4 d [IQR, 1-7 d]; p < 0.001) as compared with controls. In a multivariate logistic model, greater IMV duration (adjusted odds ratio, 1.09; 95% CI, 1.01-1.17; p = 0.023) was independently associated with HA-VTE. Conclusions: Among critically ill children undergoing IMV, HA-VTE was associated with greater IMV duration. If prospectively validated, IMV duration should be included as part of prothrombotic risk stratification and future pediatric thromboprophylaxis trials. Competing Interests: Dr. Sochet’s institution received funding from the National Center for Advancing Translational Science (UL1TR001855) and Takeda Pharmaceuticals U.S.A. Drs. Jaffray and Faustino received support for article research from the National Institutes of Health (NIH). Dr. Jaffray disclosed she is on the Ad Board for Octapharma, Genentech, and HEMA Biologics. Dr. Branchford received funding from Novo Nordisk, Bioproducts Laboratories/Kedrion, Sana Biological, and ROMTech. Dr. Amankwah received funding from Pfizer and Bristol Myers Squibb. Dr. Faustino’s institution received funding from the NIH and Grifols Shared Services of North America; they disclosed equipment loan from Diagnostica Stago. Dr. Goldberg received funding from Anthos Therapeutics, Bayer, Boehringer Ingelheim, and Daiichi Sankyo. The remaining authors have disclosed that they do not have any potential conflicts of interest. (Copyright © 2023 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu