Thrombosis associated with right internal jugular central venous catheters: A prospective observational study

Abstract

Background and Aims:Central venous catheters (CVC) are essential in a critical care setting. Thrombosis is one of the very important associated complications that can lead to increased morbidity and mortality. The aim of this study was to find out the incidence of thrombosis in right-sided internal jugular vein (IJV) CVC with the help of color Doppler duplex sonography, its extent, risk factors and clinical impact.Materials and Methods:One hundred consecutive patients having right-sided IJV CVC were included in the study. Color Doppler sonography was performed on the 3rd and 6th days after CVC insertion. The size of the thrombus was noted. Presence of diabetes mellitus, hypertension or smoking was noted. Presence of any hypertonic solution and thromboprophylaxis for Deep vein thrombosis (DVT) were also noted.Results:Thrombus was detected in 33 of 100 (33.0%) patients. The incidence in males was 32.86% and in females was 33.33%. Males had a significantly higher incidence of small thrombus (P = 0.05), whereas females had a significantly higher incidence of large thrombus (P = 0.05). DVT thromboprophylaxis was not effective for CVC-related thrombosis. Hypertonic solution, presence of diabetes, hypertension or history of smoking did not increase the risk of thrombosis.Conclusion:CVC-related thrombosis is common and has the potential for serious complications. Females appear to be at a higher risk for larger thrombus formation. DVT thromboprophylaxis does not confer protection for CVC-related thrombosis. Color Doppler duplex sonography provides with an easily available, noninvasive means of detecting a thrombus. More studies are needed to establish a consensus for prophylaxis and treatment of asymptomatic CVC-related thrombosis.

Thrombosis associated with internal jugular vein cannulation in diabetics and hypertensives: a prospective observational study

“…Within a short period after insertion, there is deposition of platelet, fibrin and collagen on the surface of the catheter forming a sheath around it. 8 This usually does not affect the catheter function but the fibrin sheath present at the tip can cause partial catheter occlusion resulting in failure to aspirate blood without interruption to flow of fluids. 9 This fibrin sleeve promotes thrombus formation which can further progress to a mural thrombus characterised by thrombus beyond the catheter into the vein partially or completely occluding the vein.…”

Three-Dimensional Imaging of a Central Venous Dialysis Catheter Related Infected Thrombus

“…The reported incidence of central catheter venous thrombosis varies between 1.5 and 33% depending on the definition [ 1 , 2 ]. Factors that predispose to thrombosis are described in Virchow's triad: hypercoagulability, hemodynamic disturbance (stasis or turbulence), and endothelial damage.…”

Oblique-axis view should be the preferred view for ultrasound-guided internal jugular vein cannulation in intensive care unit

“…In these patients there is possibility of thrombus formation in the central vein. [ 2 3 ] We report here a case with easy puncture of IJV, but difficulty in the insertion of guidewire due to IJV thrombus. A 68-year-old male post-renal transplantation was admitted to our ICU with breathlessness.…”