Thromboembolic Complications of Vascular Catheters Used for Pediatric Continuous Renal Replacement Therapy: Prevalence in a Single-Center, Retrospective Cohort*

OBJECTIVES: Pediatric venous thromboembolic events are commonly associated with in situ central venous catheters. The risk for severe venous thromboembolism increases if a larger portion of the vessel lumen is occupied by the central venous catheter. A functioning vascular catheter is required when the continuous renal replacement therapy is used in critically ill children. Due to the high blood flow required for continuous renal replacement therapy, the external diameter of the catheter needs to be larger than a conventional central venous catheter used for venous access, potentially increasing the risk of venous thromboembolism. However, children on continuous renal replacement therapy often receive systemic anticoagulation to prevent filter clotting, possibly also preventing venous thromboembolism. The frequency of catheter-related venous thromboembolic events in this setting has not been described. Our main objective was to determine the prevalence of catheter-related venous thromboembolism in pediatric continuous renal replacement therapy. DESIGN: Retrospective cohort study. SETTING: Tertiary multidisciplinary academic pediatric hospital. PATIENTS: Patients 0–18 years old with a vascular catheter used for continuous renal replacement therapy. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: In our series of 80 patients, we used 105 vascular catheters. The median age of the patients was 10 months and PICU mortality rate was ...
Source: Pediatric Critical Care Medicine - Category: Pediatrics Tags: Renal Critical Care Source Type: research

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Pulmonary embolism (PE) is caused by blockage of pulmonary arteries by thrombus, which is developed in deep veins and travels through the blood stream. The major sources of thrombus are veins in lower extremities, whereas deep vein thrombosis (DVT) in upper extremities rarely occurs spontaneously and sometimes develops as a complication of central venous catheter placement or cancer,1 although DVT in upper extremities could be increasing due to widespread use of central venous catheters and increase in cancer survivors.
Source: International Journal of Cardiology - Category: Cardiology Authors: Tags: Editorial Source Type: research
The objective of this study is to determine the safety and effectiveness of a risk-stratified, venous thromboembolism (VTE) prophylaxis intervention.
Source: Thrombosis Research - Category: Hematology Authors: Tags: Full Length Article Source Type: research
Semin Thromb Hemost DOI: 10.1055/s-0041-1725116Upper extremity deep vein thrombosis (UEDVT) has been increasing in incidence due to the escalating use of central venous catheters such as peripherally inserted central catheters. UEDVT can be primary idiopathic or secondary to pacemaker leads, intravascular catheters or cancer. In comparison to conventional venous thromboembolism such as lower limb deep vein thrombosis or pulmonary embolism the risk factors, investigations, and management are not well defined. We review current evidence in primary and secondary UEDVT, highlighting areas in need of further research. We also e...
Source: Seminars in Thrombosis and Hemostasis - Category: Hematology Authors: Tags: Review Article Source Type: research
Authors: Joga S, Bansal A, Talwar V, Bothra SJ, Dash P, Goel V, Koyyala VPB Abstract Peripherally inserted central catheters (PICC) are widely used in oncology for administration of chemotherapy. However, sometimes there may be complications associated with them such as infections, thrombosis and rarely fracture of catheter and embolization of the catheter fragments. Here we report a case of 59-year old gentleman with locally advanced carcinoma of head of pancreas, who had spontaneous fracture of a silicon based PICC and later migration of the catheter fragment through the heart and further into the right pulmonary...
Source: The Journal of Vascular Access - Category: Surgery Tags: J Vasc Access Source Type: research
Authors: Battisha A, Madoukh B, Sawalha K Abstract Right atrial thrombus can originate from distal venous sources or can be iatrogenic secondary to placement of central venous catheters, atrial devices, or surgeries. One of the most common complications of central venous catheters (CVCs) is thromboembolism, which can be either fixed to the right atrium or can be free-floating. Device-related right atrial thrombosis (RAT) can result in catheter occlusion, vascular occlusion, infection, and pulmonary embolism. The true incidence of these complications is unknown because the diagnosis may not be considered in asymptom...
Source: Current Cardiology Reviews - Category: Cardiology Tags: Curr Cardiol Rev Source Type: research
Conclusions: We report a 100% occurrence of venous thromboembolism in critically ill patients supported by venovenous extracorporeal membrane oxygenation for severe acute respiratory syndrome coronavirus 2-related acute respiratory distress syndrome using CT scan imaging despite a high target and close monitoring of anticoagulation.
Source: Critical Care Medicine - Category: Emergency Medicine Tags: Online Brief Reports Source Type: research
Authors: Benhamou Y, Sauvètre G, Grangé S, Veyradier A, Coppo P Abstract INTRODUCTION: Thrombotic thrombocytopenic purpura (TTP) is a devastating disease characterized by disseminated microvascular thrombosis. Despite pro-thrombotic predisposing conditions, the prevalence of macrovascular venous thrombosis event (VTE) in immune-mediated TTP (iTTP) has rarely been assessed. METHODS: We reviewed data of all iTTP patients of the French reference Center for thrombotic microangiopathies registry prospectively enrolled through a 10-year period, between 2008 and 2018. Venous thrombosis included either th...
Source: Revue de Medecine Interne - Category: Internal Medicine Tags: Rev Med Interne Source Type: research
While acute respiratory infections are known to increase thrombosis risk [1], the incidence of venous thromboembolic events (VTE) in patients with coronavirus disease 2019 (COVID-19) is higher than with other pathogens [2,3]. A variety of potential risk factors for thrombosis particularly present in critically-ill patients have been proposed including severe hypoxemia, thrombo-inflammation, endothelial dysfunction, pulmonary micro-CLOTs on top of recognized features such as immobilization, respiratory failure, mechanical ventilation and central venous catheter use [4].
Source: Thrombosis Research - Category: Hematology Authors: Tags: Letter to the Editors-in-Chief Source Type: research
Conclusion: Recent clinical practice guidelines recommend against the routine use of any anticoagulant thromboprophylaxis in patients with central venous catheters, but for patients at particularly high risk for CRT, consideration can be given to using higher doses of anticoagulant as prophylaxis, although there are virtually no data to support this approach.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
CONCLUSION: CEUS opens up new possibilities for bedside monitoring of pleural reactive inflammatory or peripheral thrombus embolism in severe cases of COVID-19 infection. PMID: 32538830 [PubMed - as supplied by publisher]
Source: Clinical Hemorheology and Microcirculation - Category: Hematology Authors: Tags: Clin Hemorheol Microcirc Source Type: research
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