Central venous lines in critically ill children: Thrombosis but not infection is site dependent
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In brief
In brief
This retrospective study of 2,714 central venous catheters in critically ill children found that catheter-related thrombosis risk varies significantly by insertion site, while infection rates do not. Percutaneous CVCs showed the highest thrombosis incidence at 7.5 per 1000 line-days, informing site selection strategies in pediatric intensive care.
Written by the GCMD Library team from the article.
Background
Central venous catheters (CVC) are vital to the management of critically ill children. Despite efforts to minimize complications, central line associated bloodstream infection (CLABSI) and venous thromboembolisms (VTE) still occur.
Methods
We performed a retrospective review of a prospectively collected database for children admitted to the pediatric intensive care unit (PICU) between November 2013 and December 2016.
Results
In total, 2714 CVC were in place, 979 of which were percutaneous CVC. During the study period, 21 CLABSI (1.6/1000 line days) were identified, of which, nearly half (n = 9, 42.9%) were associated with percutaneous CVC (2.6/1000 line days). Poisson regression analysis did not identify a single risk factor for CLABSI when adjusting for line type, anatomic location and laterality of placement, geographic location of placement, length of PICU admission, presence of gastrostomy tube, concurrent mechanical ventilation, age, weight, and height. Forty clinically significant VTE (2.9/1000 line days) were identified, with percutaneous CVC having the highest incidence (7.5/1000 line days, p