Deep venous thrombosis caused by femoral venous catheters in critically ill adult patients
| Autor: | Charles D. Gomersall, Vivian Yee-Fong Leung, E. K. H. Liu, Gavin M. Joynt, J. Kew |
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| Rok vydání: | 2000 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult Male medicine.medical_specialty Catheterization Central Venous Deep vein Critical Illness Femoral vein Critical Care and Intensive Care Medicine Hospitals University Risk Factors medicine Humans Prospective Studies Prospective cohort study Venous Thrombosis Ultrasonography Doppler Duplex Vascular disease business.industry Femoral Vein Middle Aged medicine.disease Thrombosis Surgery Venous thrombosis Catheter Intensive Care Units medicine.anatomical_structure Anesthesia Hong Kong Female Cardiology and Cardiovascular Medicine Complication business |
| Zdroj: | Chest. 117(1) |
| ISSN: | 0012-3692 |
| Popis: | Study objectives To determine the frequency of andpotential risk factors for catheter-related deep venous thrombosis(DVT) in critically ill adult patients. Design Prospective, controlled, observational cohort study. Setting A mixed medical and surgical ICU in a universityhospital. Patients All adult patients undergoingfemoral vein catheterization. Interventions None. Measurements ICU diagnosis, underlying disease, demographic data, type of catheter, complications during cannulation, use of anticoagulants, coagulation status, medications infused, andduration of catheterization were recorded. Compression and duplex Doppler ultrasound studies of both femoral veins were performed priorto insertion, at 12 h after insertion, and daily until catheterremoval. Follow-up investigation was performed at 24 h and 1 weekafter removal. Results Of 140 cases entered into thestudy, 124 were evaluated. Fourteen patients developed iliofemoral veinDVTs. Two were clinically obvious. Twelve (9.6%) were line related(uncannulated leg normal) and two (1.6%) occurred only in theuncannulated leg (p = 0.011; relative risk, 6.0; confidence interval,1.5 to 23.5). Line-related DVT can occur any time from the day afterinsertion to 1 week after removal. The incidence of catheter-relatedDVT was unrelated to number of insertion attempts, arterial puncture orhematoma, duration of catheterization, coagulation status, or type ofinfused medications. No other predisposing or protective factors wereidentified. Three of the 12 patients with catheter-related DVT died. Inno patient was clinical pulmonary embolus suspected. Conclusion Although the femoral route is convenient andhas potential advantages, the use of femoral lines increases the riskof iliofemoral DVT. Catheter-related DVT may occur as soon as 1 dayafter cannulation and is usually asymptomatic. This increased riskshould be carefully considered when the femoral route of cannulation ischosen. |
| Databáze: | OpenAIRE |
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