Ultrasound in Central Venous Catheter-Related Thrombosis Diagnosis among Children at Intensive Care Unit
Abstract
Ultrasound follow-up of central venous patency was provided in 72 most severe patients (with severe combined trauma or acute surgery abdominal pathology). Age of patients varied from 1.5 up to 17 years old. High risk of central venous thrombosis persisted in severe patients in critical life conditions in spite of preventive treatment with heparin. 25 thrombi of different location and degree of occlusion were revealed among 17 from 72 (23.6%) patients. Thrombi were localized in internal jugular (12), femoral (6), external iliac (5), and subclavian (2) veins. They were classified according to degree of occlusion as follows: nonocclusive thrombi - 14 (56.0%), floating - 5 (20.0%), totally occlusive - 6 (24.0%) (4 in internal jugular vein, 1 in subclavian vein, 1 in femoral vein). Ultrasound follow-up of central venous patency is required among children at intensive care unit due to absence of venous thrombosis clinical symptoms among majority of patients (15 (88.2%) among 17 patients) and severe complications including the pulmonary thromboembolism (2 (11.8%) among 17 patients).
About the Authors
M. V. Bykov
Children’s Clinical and Research Institute of Emergency Surgery and Trauma, Moscow;
Pirogov Russian National Research Medical University, Moscow
Russian Federation
Russian Federation
K. S. Madorskii
Children’s Clinical and Research Institute of Emergency Surgery and Trauma, Moscow
Russian Federation
Russian Federation
V. G. Bagaev
Children’s Clinical and Research Institute of Emergency Surgery and Trauma, Moscow
Russian Federation
Russian Federation
V. G. Amcheslavskii
Children’s Clinical and Research Institute of Emergency Surgery and Trauma, Moscow
Russian Federation
Russian Federation
V. V. Lazarev
Pirogov Russian National Research Medical University, Moscow
Russian Federation
Russian Federation
References
1. Лелюк В.Г., Лелюк С.Э. Ультразвуковая ангиология. М.: Реальное время, 2007. 416 с.
2. Ма О.Дж., Матиэр Дж.Р., Блэйвес М. Ультразвуковое исследование в неотложной медицине. Изд. 2-е. М.: Бином, 2013. 560 с.
3. Сутингко А.Н., Нельсон Б., Нобль В.Е. УЗИ при неотложных и критических состояниях. М.: Медицинская литература, 2009. 227 с.
4. Лекманов А.У. Протокол катетеризации вен у детей. М., 2008. 20 с.
5. Серегина Е.А., Викторова Е.А., Пашко Ю.В. и др. Катетер-ассоциированный тромбоз и коагулологические тесты у детей до года // Материалы XVIII Всероссийской научно-практической конференции “Аналитическая надежность и диагностическая значимость”. М., 2013. С. 56.
6. Andrew M., Marzinotto V., Pencharz P. et al. A cross-sectional study of catheter-related thrombosis in children receiving total parenteral nutrition at home // J. Pediatr. 1995. V. 126. No. 3. P. 358-363.
7. Balestreri L., De Cicco M., Matovic M. et al. Central venous catheter-related thrombosis in clinically asymptomatic oncologic patients: a phlebographic study // Eur. J. Radiol. 1995. V. 20. No. 2. Р. 108-111.
8. Marinella M.A., Kathula S.K., Markert R.J. Spectrum of upper-extremity deep venous thrombosis in a community teaching hospital // Heart Lung. 2000. V. 29. No. 2. Р. 113-117.
9. Timsit J.F., Farkas J.C., Boyer J.M. et al. Central vein catheter-related thrombosis in intensive care patients: incidence, risks factors, and relationship with catheter-related sepsis // Chest. 1998. V. 114. No. 1. Р. 207-213.
10. Hamilton H., Bodenham A.R. Central Venous Catheters. NY: John Wiley & Sons, 2009. 249 p.
11. Faustino E.V., Spinella P.C., Li S. et al. Incidence and acute complications of asymptomatic central venous catheter-related deep venous thrombosis in critically ill children // J. Pediatr. 2013. V. 162. No. 2. P. 387-391.
12. Schroeder A.R., Axelrod D.M., Silverman N.H. et al. A continuous heparin infusion does not prevent catheter-related thrombosis in infants after cardiac surgery // Pediatr. Crit. Care Med. 2010. V. 11. No. 4. P. 489-495.
13. Гольдина И.М., Трофимова Е.Ю., Кунгурцев Е.В., Михайлов И.П. Функциональные пробы в определении длины флотирующего тромба в подвздошно-бедренном сегменте при ультразвуковом исследовании // Ультразвуковая и функциональная диагностика. 2014. № 1. С. 63-72.
14. Hanslik A., Thom K., Haumer M. et al. Incidence and diagnosis of thrombosis in children with short-term central venous lines of the upper venous system // Pediatrics. 2008. V. 122. No. 6. P. 1284-1291.
15. Wiegering V., Schmid S., Andres O. et al. Thrombosis as a complication of central venous access in pediatric patients with malignancies: a 5-year single-center experience // BMC Hematol. 2014. V. 14. No. 1. P. 18.
Review
For citations:
Bykov M.V., Madorskii K.S., Bagaev V.G., Amcheslavskii V.G., Lazarev V.V. Ultrasound in Central Venous Catheter-Related Thrombosis Diagnosis among Children at Intensive Care Unit. Ultrasound & Functional Diagnostics. 2015;(2):85-93. (In Russ.)
Views:
30
JATS XML
Email this article 