Incidence and risk factors of catheter-related deep vein thrombosis in a pediatric intensive care unit: a prospective study.
OBJECTIVE
To estimate the incidence and to characterize risk factors for central venous catheter (CVC)-related deep vein thrombosis (DVT) in a pediatric intensive care unit.


METHODS
Consecutive children admitted to a pediatric intensive care unit who required a CVC for more than 48 hours were examined by Doppler ultrasonography of the catheterized vein at days 2, 4, 6, or 7 after insertion and weekly thereafter until CVC removal.


RESULTS
The incidence of CVC-related DVT was 18.3% (17 of 93) (95% confidence interval = 10.2% to 25.8%). Thromboses were diagnosed within the first 4 days of catheter placement for 15 of 17 CVC-related thromboses. Multivariate analysis showed that risk factors most predictive of CVC-related DVT were presence of a cancer (odds ratio = 17.23, 95% confidence interval = 1.5 to 194) and young age (odds ratio for age = 0.72, 95% confidence interval = 0.54 to 0.96).


CONCLUSIONS
The frequency of CVC-related DVT is substantial in pediatric intensive care units. Risk is highest during the 4 days after insertion and decreases thereafter. The clinical impact, optimal prevention, and therapy of these thromboses remain to be determined.
Department of Pediatrics, Hôpital Sainte-Justine, Université de Montréal, Québec, Canada.
C
C
Beck
J
J
Dubois
A
A
Grignon
J
J
Lacroix
M
M
David
D002405:Catheterization, Central Venous / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D006801:Humans; D015994:Incidence; D007223:Infant; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D011446:Prospective Studies; D011792:Quebec; D012307:Risk Factors; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D014463:Ultrasonography