Catheter-related thrombosis in children with cancer

Glaser, Darryl W.; Medeiros, Desiree; Rollins, Nancy; Buchanan, George R.

doi:10.1067/mpd.2001.111272

Cited by 131 publications

(115 citation statements)

References 28 publications

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“…Good evidence indicates that CVL-related VTEs frequently remain clinically undetected; therefore, clinical endpoints alone are inappropriate for such a study. 12,14,22 Recent evidence also shows that ultrasound is insensitive for VTE in the subclavian vein and that venography is insensitive for VTE in the jugular vein. 23,24 Hence, when screening for VTE in the 2 locations, both venography and ultrasound are required.…”

Section: Introductionmentioning

confidence: 99%

Central venous line–related thrombosis in children: association with central venous line location and insertion technique

Male

Chait

Andrew

et al. 2003

Blood

223

164

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Venous thromboembolic events (VTEs) in children are associated with central venous lines (CVLs). The study objective was to assess whether CVL location and insertion technique are associated with the incidence of VTE in children. We hypothesized that VTE would be more frequent with (1) CVL location on the left body side, (2) CVL location in the subclavian vein rather than the jugular vein, and (3) CVL insertion by percutaneous technique rather than venous cut-down. This was a prospective, multicenter cohort study in children with acute lymphoblastic leukemia who had a CVL placed in the upper venous system during induction chemotherapy. Characteristics of CVL were documented prospectively. All children had outcome assessment for VTE by objective radiographic tests, including bilateral venography, ultrasound, echocardiography, and cranial magnetic resonance imaging. Among 85 children, 29 (34%) had VTE; 28 VTEs appeared in the upper venous system, and 1 was sinovenous thrombosis. Left-sided CVL (odds ratio [OR], 2.5; 95% confidence interval, 1.0-6.4; P ‫؍‬ .048), subclavian CVL (OR, 3.1; 95% CI, 1.2-8.5; P ‫؍‬ .025), and percutaneous CVL insertion (OR, 3.5; 95% CI, 1.3-9.2; P ‫؍‬ .011) were associated with an increased incidence of VTE. Interaction occurred between CVL vein location and insertion technique. Subclavian vein CVL inserted percutaneously had an increased incidence (54%) of VTE compared with any other combination (P ‫؍‬ .07). For CVL in the upper venous system, CVL placement on the right side and in the jugular vein may reduce the risk for CVL-related VTE. If subclavian vein placement is necessary, CVL insertion by venous cutdown appears preferable over percutaneous insertion.

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Section: Introductionmentioning

confidence: 99%

Central venous line–related thrombosis in children: association with central venous line location and insertion technique

Male

Chait

Andrew

et al. 2003

Blood

223

164

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“…1 Previous experience has demonstrated increased incidence of DVT in children with chronic conditions such as malignancy or congenital heart disease or with acute infection, surgery, trauma, or hypovolemia. 9,10 Diabetes mellitus has not been described as a specific isolated risk factor for DVT in children, although a propensity for hypercoagulability has been noted in diabetic adults. 11 Despite growing experience regarding CVC-related thrombosis in children, increased risk of CVCassociated DVT in children with diabetic ketoacidosis (DKA) was not described until a recent case series.…”

mentioning

confidence: 99%

“…The median patient age in controls was 2.5 years (range: 1-16 years). CVC duration was significantly shorter in DKA patients (median 2 days [range: 1.5-4] vs 7 days [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] in control patients; P ϭ .05). Clinical evidence of DVT was not reported in any non-DKA shock patient.…”

mentioning

confidence: 99%

Deep Venous Thrombosis in Children With Diabetic Ketoacidosis and Femoral Central Venous Catheters

et al. 2004

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ABSTRACT. Objective. To describe findings of deep venous thrombosis (DVT) in association with femoral central venous catheter (CVC) placement for intensive fluid management in children with diabetic ketoacidosis (DKA) secondary to type 1 diabetes.Design. Retrospective cohort study. Setting. Pediatric intensive care unit (PICU) of a children's referral medical center.Patients. DKA patients from 1998 to 2002 of children with DKA with and without CVC placement. DKA patients were also compared with all PICU patients with CVC. CVC DVT was defined as ipsilateral leg swelling with CVC placement, confirmed by radiographic study, and persisting after CVC removal.Measurements and Main Results. Of 113 DKA PICU patients, 6 (5.3%) required femoral CVC for initial management. Three of these DKA/CVC patients developed ipsilateral DVT within 48 hours of CVC placement. All 3 patients required long-term therapy with low molecular weight heparin for persistent leg swelling. DKA/CVC patients with DVT were younger (median age: 10.5 months) than DKA/CVC patients without DVT. The number of DKA/CVC patients with DVT (1.4%) was significantly greater than for all femoral non-DKA/CVC patients. DKA/CVC patients were also significantly more likely to have DVT than age-matched shock/CVC patients. They also had significantly higher glucose, corrected sodium concentrations, and lower pH and serum bicarbonate than did age-matched shock/CVC patients.Conclusions. Femoral CVC placement is infrequently needed in pediatric DKA patients but can be associated with DVT. Femoral CVCs should be avoided in DKA patients or removed as soon as possible. DVT prophylaxis should be considered if a CVC is required. C entral venous catheter (CVC) placement can be essential for providing fluids and medications in the treatment of the child with hypoperfusion and difficulty obtaining adequate peripheral access. CVCs, however, are associated with a variety of infectious and noninfectious complications. 1,2 Both percutaneous and chronic indwelling CVCs are a significant risk factor for deep venous thrombosis (DVT) in children. 1,2 Pediatric venous thromboembolism registries have reported that 28% to 50% of DVT episodes in children occurred in the presence of an acute or chronic CVC. 3,4 The reported incidence of DVT in pediatric intensive care unit (PICU) patients with a CVC ranges widely depending on whether clinical or radiographic evidence of DVT is evaluated. 1,[5][6][7][8] One prospective study of acute CVC placement in PICU patients found a 7.5% incidence of symptomatic DVT but an incidence of 18.3% based on radiographic evidence. 1 Previous experience has demonstrated increased incidence of DVT in children with chronic conditions such as malignancy or congenital heart disease or with acute infection, surgery, trauma, or hypovolemia. 9,10 Diabetes mellitus has not been described as a specific isolated risk factor for DVT in children, although a propensity for hypercoagulability has been noted in diabetic adults. 11 Despite growing experience regarding CVC-relat...

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“…Результаты различных исследований показывают, что наиболее часто ВТ встре-чаются у детей с лимфомами (21,05 %), саркомами (15,62 %) и опухолью Вильмса (42,50 %). При остром лимфобластном лейкозе ВТ выявляются в 10,89 % слу-чаев [3][4][5][6].…”

Section: обзор литературыunclassified

Portal vein thrombosis in a patient with a malignant rhabdoid tumor of the liver (Case report)

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2015

Ross. ž. det. gematol. onkol.

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Catheter-related thrombosis in children with cancer

Cited by 131 publications

References 28 publications

Central venous line–related thrombosis in children: association with central venous line location and insertion technique

Central venous line–related thrombosis in children: association with central venous line location and insertion technique

Deep Venous Thrombosis in Children With Diabetic Ketoacidosis and Femoral Central Venous Catheters

Portal vein thrombosis in a patient with a malignant rhabdoid tumor of the liver (Case report)

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