Duplex scanning of central vascular access sites in burn patients.
Seventy-one burned patients requiring intensive care unit management underwent 570 central venous and 167 femoral arterial catheterizations. These patients were surveyed by repeated physical examinations and duplex scans for vascular-related complications. Catheter sites were rotated every 3 days. No arterial thrombi or occlusions were noted. Fourteen patients (19.6%) had 19 positive venous duplex scans. Five patients (7%) had symptomatic deep venous thrombosis (DVT) and nine (12.6%) had asymptomatic DVT. Mean number of venous cannulations before a positive scan was 4.3 (range 1 to 17). All five symptomatic patients had DVT that originated in the lower extremities. No patient had clinical evidence of a pulmonary embolus, or limb morbidity resulting from the DVT. Follow-up duplex scans in the five asymptomatic and three symptomatic patients showed complete resolution in each case. This study demonstrates the high incidence and natural history of central DVT in a group of critically ill burn patients.
Wait
M
M
Parkland Memorial Hospital, Dallas, Texas.
Hunt
J L
JL
Purdue
G F
GF
D000328:Adult; D002053:Burn Units; D002056:Burns / Q000628:therapy*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002406:Catheterization, Peripheral / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D013924:Thrombophlebitis / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D014463:Ultrasonography / Q000379:methods*