Ultrasound screening for internal jugular vein thrombosis aids the detection of central venous catheter‐related infections in patients with haemato‐oncological diseases: a prospective observational study

Abstract

Summary. To prove the hypothesis that central venous catheter‐related thrombosis and infection are associated, 43 haemato‐oncological patients with an internal jugular vein catheter underwent ultrasound screening for thrombosis every 4 d. Catheter‐related thrombosis was detected in 13/43 patients (30%). Catheter‐related infection, as defined by the U.S. Hospital Infection Control Practices Advisory Committee, was found in 14/43 patients (33%) with colonization of the catheter in two patients, exit site infection in eight patients and catheter‐related bloodstream infection in four patients. Catheter‐related thrombosis and catheter‐related infection coincided in 12 patients and were significantly correlated (Fisher's exact test, P < 0·0001). Detection of thrombosis indicated a catheter‐related infection with a superior sensitivity (86%vs 57%) and an equivalent specificity (97%) compared with the presence of clinical signs (erythema, tenderness, warmth or swelling). Neutropenia, which occurred in 32 patients, was found in 13/14 patients (93%) with a catheter‐related infection and, therefore, seemed to be an important covariate for the development of a catheter‐related infection. This study showed a close correlation between catheter‐related thrombosis and infection. Ultrasound screening for thrombosis was helpful for detecting catheter‐related infection. These findings could be clinically useful for the handling of central venous catheters in patients with an elevated risk of infectious complications.

Infectious Complications of Central Venous Catheters Increase the Risk of Catheter-Related Thrombosis in Hematology Patients: A Prospective Study

“…4 In hemato-oncology patients, only one small study (n ϭ 42) has been performed, in which a direct association of infection and thrombosis was reported. 5 In this study, daily screening using ultrasound for (subclinical) thrombosis was used to estimate the risk of subsequent CVC-related infection. From 13 patients with documented subclinical thrombosis, CVC-related infection occurred in 12 (92%), whereas in 29 patients without thrombosis, the number of infections was only two (7%).…”

“…[3][4][5] However, the reported thrombotic events were subclinical and were often diagnosed at CVC removal. Whether CVC-related infection increases the risk of clinically manifest thrombosis while the CVC remains in place is unknown.…”

Achados clínicopatológicos na tromboembolia pulmonar: estudo de 24 anos de autópsias

“…In most patients with infectious diseases (64.0%), there was no antemortem suspicion of PTE. Although the exact relationship between infection and PTE has not been elucidated, venous thromboembolism is a frequent complication of septicemia, and PTE has been diagnosed in septicemic patients who were submitted to central venous catheterization or to surgery involving the abdomen or pelvis (9,14,15) . It is difficult to identify PTE in trauma patients because such patients are frequently unable to report their symptoms due to intubation or coma.…”

An unusual cause of respiratory failure in a colon cancer patient

“…The most commonly reported complications of CVCs are infections and thrombosis. The incidence of CVC-related thrombosis was reported to be ~30% in adults (1). The clinical manifestations sometimes are obvious, with congestion of the collateral veins of the shoulder and chest wall on the affected side; however, thrombosis of the deep veins may occasionally be asymptomatic or present with mild symptoms.…”

“…The clinical manifestations sometimes are obvious, with congestion of the collateral veins of the shoulder and chest wall on the affected side; however, thrombosis of the deep veins may occasionally be asymptomatic or present with mild symptoms. Rarely, CVC may be associated with the development of an atrial mass as a consequence of a CVC-related organized thrombus located inside the atrial cavity (1).…”