Thermoregulatory Catheter–Associated Inferior Vena Cava Thrombus
| Autor: | Joshua L. Gierman, William P. Shutze, Gregory J. Pearl, Michael L. Foreman, Stephen E. Hohmann |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
Resuscitation medicine.diagnostic_test business.industry Deep vein General Medicine 030204 cardiovascular system & hematology medicine.disease Thrombosis Occult Inferior vena cava Surgery Multipatient Studies 03 medical and health sciences Catheter 0302 clinical medicine medicine.anatomical_structure medicine.vein Intravascular ultrasound cardiovascular system medicine cardiovascular diseases 030212 general & internal medicine Thrombus business |
| Zdroj: | Baylor University Medical Center Proceedings. 26:100-102 |
| ISSN: | 1525-3252 0899-8280 |
| Popis: | The use of thermoregulatory catheters (TRCs) in critically ill patients has become increasingly popular. TRCs have been shown to be effective in regulating patient body temperature with improved outcomes. Critically ill patients, especially multitrauma patients and those with femoral catheters, are at high risk for deep vein thrombosis (DVT). Among patients for whom chemical DVT prophylaxis is not an option, inferior vena cava (IVC) filters are often placed prophylactically. The development of intravascular ultrasound (IVUS) has allowed placement of IVC filters at the bedside for patients who are too ill for transport to the operating room or cardiac catheterization lab. After encountering several patients with occult DVT of the IVC during bedside IVC filter placement, we performed a retrospective review to determine the incidence of DVT or pulmonary embolus (PE) in patients who had been treated with a TRC at Baylor University Medical Center at Dallas. Since 2008, IVC filters have been deployed at the bedside with the use of IVUS at Baylor University Medical Center. During that same time period, 83 patients had a TRC placed for either intravascular warming or cooling during their resuscitation. Forty-seven out of 83 patients who had a TRC placed survived their injuries. Ten of 47 patients (21%) were diagnosed with DVT or PE, and 6 of these 10 (60%) were found to have caval thrombus. We present this case series as evidence that undiagnosed IVC thrombus associated with TRCs may be higher than previously suspected, given that 5 out of 10 patients who had IVUS of their IVC for prophylactic IVC filter placement, as well as one patient diagnosed with PE, were found to have caval thrombus. |
| Databáze: | OpenAIRE |
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