Central venous catheter related thrombosis in children: Analysis of the Canadian Registry of Venous Thromboembolic Complications☆,☆☆,★,★★
Section snippets
Participating Centers
The Canadian Childhood Thrombophilia Registry comprises 16 Canadian tertiary pediatric centers (Appendix). Patients in this report were entered from July 1, 1990 to December 31, 1996 for a total of 78 months.
A designated pediatric hematologist at each center maintained a prospective list of consecutive children with documented DVT referred to their service, prompted by a mailed reminder monthly. In addition, medical records in each institution used specific codes for thrombotic complications
RESULTS
Consecutive children with CVL-related DVT (n = 241) were entered into the registry and constituted 60% of the broader registry of all VTE (n = 405). The geographic distribution of patients reflected both the size of the participating institutions and centralization of resources in Canada. The median duration of follow-up was 24 months (range 3 months to 7 years). The total number of admissions per center during the time of the registry was used to calculate an incidence of CVL-related DVT in
DISCUSSION
The major complications of venous access lines are sepsis and CVL-related DVT.2 We reviewed our experience with a consecutive cohort of 244 children with CVL-related DVT. The mortality and morbidity rates associated with this complication support the need for prophylactic trials to prevent CVL-related DVT.
The incidence of CVL-related DVT in children in our study, 3.5 per 10,000 hospital admissions per year, is likely an underestimate. CVL-related DVTs accounted for 60% of all childhood DVTs
Acknowledgements
The authors acknowledge the directors of the Canadian Childhood Thrombophilia Program for their contribution to this study. The contributors are as follows: Kaiser Ali, Dorothy Barnard, Mark Bernstein, Linda Brisson, Michele David, Sunil Desai, Marie-Francis Scully, Jacqueline Halton, Sara Israels, Lawrence Jardine, Michael Leaker, Patricia McCusker, Marianna Silva, John Wu, Ron Anderson.
References (49)
- et al.
Venous thromboembolic complications (VTE) in children: first analyses of the Canadian Registry of VTE
Blood
(1994) - et al.
Fatal pulmonary embolism following removal of a central venous catheter
J Pediatr Surg
(1984) - et al.
Complications of superior versus inferior vena cava occlusion in infants receiving central total parenteral nutrition
J Pediatr Surg
(1984) - et al.
Complications of TPN catheter-induced vena caval thrombosis in children less than one year of age
J Pediatr Surg
(1983) - et al.
Venous thromboembolism complications in children: a critical review of the literature
J Pediatr
(1993) - et al.
A cross-sectional study of catheter-related thrombosis in children receiving total parenteral nutrition at home
J Pediatr
(1995) - et al.
Right atrial thrombi in children with cancer and indwelling catheters
J Pediatr
(1996) - et al.
Incidence of thrombosis during central venous catheterization of newborns: a prospective study
J Pediatr Surg
(1992) - et al.
Subclavian broviac catheters in children: technical consideration in 146 consecutive placements
J Pediatr Surg
(1985) - et al.
Continuous venous access in children for long-term chemotherapy by means of an implantable system
J Pediatr Surg
(1986)
Thrombosis and embolism in long-term central venous access for parenteral nutrition
Lancet
Defatting catheter insertion sites in total parenteral nutrition is of no value as an infection control measure
Am J Med
Hemorrhagic and thrombotic complications in children with cancer
Hemorrhagic and Thrombotic Complications in Children
Neonatal thrombosis: report of a prospective Canadian and International registry
Pediatrics
Very low doses of warfarin can prevent thrombosis in central venous catheters. A randomized prospective trial
Ann Intern Med
The mechanism of the effect of aspirin on human platelets. I. acetylation of a particulate fraction protein
J Clin Invest
Venographic assessment of deep vein thrombosis and risk of developing post-thrombotic syndrome: a prospective study
J Int Med
The Caval Catheter
Aggressive or conservative treatment in subclavian vein thrombosis
Primary subclavian-axillary vein thrombosis
Circulation
Natural history of major venous thrombosis of the upper extremity
Arch Surg
Deep venous thrombosis of the upper extremity, five years experience at a university hospital
Angiology
Venous catheter thrombus formation and pulmonary embolism in children
Pediatr Pulmonol
Cited by (379)
Anticoagulation of pediatric patients with venous thromboembolism in 2023
2024, Thrombosis ResearchDabigatran in the treatment and secondary prophylaxis of venous thromboembolism in children with thrombophilia
2022, Blood AdvancesCitation Excerpt :The VTE recurrence rate has been reported to be ∼3% in newborns and 8% in older children,6,11 with risk increasing to as high as 29% in children with certain inherited thrombophilia traits.12 VTE-related death in children has been reported to be 0% to 3.7% and PTS has been reported with a frequency of 9.5% to 70%.13-15 Anticoagulation is the standard treatment for VTE.16
Management of pediatric intestinal failure related to short bowel syndrome
2022, Seminars in Pediatric SurgeryCardiac critical care of the post-operative congenital heart disease patient
2021, Seminars in Pediatric Surgery
- ☆
From the Canadian Childhood Thrombophilia Program, Hamilton Civic Hospital Research Centre, Hamilton, Ontario, Canada, and the Department of Haematology, Hospital for Sick Children, Toronto, Canada.
- ☆☆
Supported from a grant-in-aid from the Heart and Stroke Foundation of Ontario. Dr. Andrew is a career scientist with the Heart and Stroke Foundation of Canada.
- ★
Reprint requests: Maureen Andrew, MD, Hamilton Civic Hospitals Research Centre, 711 Concession St, Hamilton, Ontario, Canada L8V 1C3.
- ★★
0022-3476/98/$5.00 + 0 9/21/94589