Central venous catheter related thrombosis in children: analysis of the Canadian Registry of Venous Thromboembolic Complications.
BACKGROUND
Central venous lines (CVLs) are frequently associated with deep venous thrombosis (DVT) in children; however, little is known about the epidemiologic characteristics or outcome of CVL-related DVT.


METHODS
The Canadian Childhood Thrombophilia Registry monitored 244 consecutive patients with objectively diagnosed CVL-related DVT for a median duration of 24 months (range 3 months to 7 years).


RESULTS
The incidence of CVL-related DVT was 3.5 per 10,000 hospital admissions. CVL-related DVTs were more frequent in the upper venous system. Ultrasonography or echocardiography were the most commonly used diagnostic tests (n = 183 patients). Venograms were performed on 82 (34%) patients. A variety of therapies were used. Thirty-nine children had pulmonary emboli, but most were not investigated for pulmonary emboli. Nine (3.7%) children died as a consequence of their thromboembolic disease. Recurrent DVT occurred in 16 (6.5%) children, and postphlebitic syndrome occurred in 23 (9.5%) children.


CONCLUSIONS
Currently no uniform guidelines exist for the prevention and management of CVL-related DVT in children. The frequency and clinical consequences of CVL-related DVTs justify controlled trials of primary prophylaxis in children requiring central venous access.
Massicotte
M P
MP
Canadian Childhood Thrombophilia Program, Hamilton Civic Hospital Research Centre, Hamilton, Ontario, Canada, and the Department of Haematology, Hospital for Sick Children, Toronto, Canada.
Dix
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D
Monagle
P
P
Adams
M
M
Andrew
M
M
D000293:Adolescent; D017677:Age Distribution; D002170:Canada / Q000453:epidemiology; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D012042:Registries; D012189:Retrospective Studies; D020246:Venous Thrombosis / Q000453:epidemiology / Q000209:etiology*