Bedside insertion of inferior vena cava filters in the intensive care unit.
BACKGROUND
Injured patients are at significant risk for venous thromboembolic complications. Multiple studies have reported a benefit of prophylactic inferior vena cava filter (IVCF) insertion in selected high-risk trauma patients. Often, these high-risk patients reside in the intensive care unit (ICU) and require mechanical ventilation, intracranial pressure monitoring, multiple intravenous infusions, and other invasive monitoring modalities. This puts these patients at risk for transport from the ICU.


METHODS
We prospectively studied a series of consecutive patients undergoing bedside preinsertion contrast cavagram and IVCF insertion in the ICU.


RESULTS
Thirty-two patients received IVCF. There were no failures to insert IVCF. One insertion-site hematoma occurred; however, there were no documented insertion-site deep venous thromboses. One patient death was unrelated to the IVCF, and one potential contrast-related acute renal failure occurred in an unstable patient who underwent IVCF insertion for a pulmonary embolus.


CONCLUSIONS
Bedside IVCF insertion with a preinsertion cavagram is a percutaneous procedure that can be safely performed in the ICU. Bedside insertion of IVCF avoids the potential complications of transporting critically ill patients and may reduce costs.
Sing
R F
RF
Department of Surgery, Carolinas Medical Center, Charlotte, North Carolina 28203, USA. rsing@carolinas.org
Cicci
C K
CK
Smith
C H
CH
Messick
W J
WJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D003663:Decision Trees; D005260:Female; D005471:Fluoroscopy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000150:complications*; D018579:Patient Selection; D019095:Point-of-Care Systems; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D015641:Radiography, Interventional / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D012307:Risk Factors; D013923:Thromboembolism / Q000209:etiology* / Q000517:prevention & control*; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging*