Characterization of central venous catheter-associated deep venous thrombosis in infants.
OBJECTIVE
Deep venous thrombosis (DVT) is a frequent complication in infants with central venous catheters (CVCs). We performed this study to identify risk factors and risk-reduction strategies of CVC-associated DVT in infants.


METHODS
Infants younger than 1 year who had a CVC placed at our center from 2005 to 2009 were reviewed. Patients with ultrasonically diagnosed DVT were compared to those without radiographic evidence.


RESULTS
Of 333 patients, 47% (155/333) had femoral, 33% (111/333) had jugular, and 19% (64/333) had subclavian CVCs. Deep venous thromboses occurred in 18% (60/333) of patients. Sixty percent (36/60) of DVTs were in femoral veins. Femoral CVCs were associated with greater DVT rates (27%; 42/155) than jugular (11%; 12/111) or subclavian CVCs (9%; 6/64; P < .01). There was a 16% DVT rate in those with saphenofemoral Broviac CVCs vs 83% (20/24) in those with percutaneous femoral lines (P < .01). Multilumen CVCs had higher DVT rates than did single-lumen CVCs (54% vs 6%, P < .01), and mean catheter days before DVT diagnosis was shorter for percutaneous lines than Broviacs (13 ± 17 days vs 30 ± 37 days, P = .02). Patients with +DVT had longer length of stay (86 ± 88 days vs 48 ± 48 days, P < .01) and higher percentage of intensive care unit admission (82% vs 70%, P = .02).


CONCLUSIONS
Deep venous thrombosis reduction strategies in infants with CVCs include avoiding percutaneous femoral and multilumen CVCs, screening percutaneous lines, and early catheter removal.
Section of Pediatric Surgery, C.S. Mott Children's Hospital, University of Michigan Health System, Ann Arbor, MI 48109, USA.
Brian W
BW
Gray
Raquel
R
Gonzalez
Kavita S
KS
Warrier
Lauren A
LA
Stephens
Robert A
RA
Drongowski
Steven W
SW
Pipe
George B
GB
Mychaliska
D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation; D015897:Comorbidity; D005260:Female; D005268:Femoral Vein / Q000473:pathology*; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007601:Jugular Veins / Q000473:pathology*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D010690:Phlebography; D012189:Retrospective Studies; D012307:Risk Factors; D040242:Risk Reduction Behavior; D013350:Subclavian Vein / Q000473:pathology*; D014463:Ultrasonography; D056824:Upper Extremity Deep Vein Thrombosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control