Risk factors analysis on central venous catheter-related thrombosis in critically ill children
10.3760/cma.j.issn.1673-4912.2025.06.007
- VernacularTitle:危重症患儿中心静脉导管相关性血栓的危险因素分析
- Author:
Hanfang DENG
1
;
Zhimin YANG
;
Wenlan ZHANG
;
Li YUAN
;
Long XIANG
;
Wenyi LUO
Author Information
1. 上海交通大学医学院附属上海儿童医学中心心胸外科 200127
- Publication Type:Journal Article
- Keywords:
Catheter related thrombosis;
Risk factors;
Critical illness;
Central venous catheter;
Children
- From:
Chinese Pediatric Emergency Medicine
2025;32(6):431-436
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the current status and risk factors of central venous catheter-related thrombus（CRT）in critically ill children，and to provide evidence for proposing preventive measures.Methods:This study was a single-center cross-sectional survey.The hospitalized children with central venous catheters implanted in the intensive care unit of Shanghai Children's Medical Center,Shanghai Jiao Tong University School of Medicine from January to March 2024 were included.Based on the ultrasound diagnosis indicating CRT or the presence of visually detectable thrombi after central venous catheter removal,the children included in the study were categorized into the CRT group and the non-CRT group.The data of demographic，clinical data，laboratory tests，medication treatment，and catheter related information of the affected children were collected.Univariate and multivariate analyses were performed to identify risk factors associated with CRT.Results:A total of 328 children were included，of which 158 cases（48.2%）were female，with the median age of 35.00（9.00，88.75）months.There were 51 cases（15.6%）in CRT group and 277 cases（84.4%）in non-CRT group.After adjusted by pediatric critical illness score，multivariate binary Logistic analysis revealed that the use of normal saline for catheter flushing and sealing (adjust OR=26.52,95% CI 8.32-84.60, P<0.001),longer duration of vasoactive drug use (adjust OR=5.06,95% CI 1.93-13.26, P=0.001),higher Caprini scale score (adjust OR=3.09,95% CI 1.38-6.91, P=0.006),presence of high-risk comorbidities or complications (adjust OR=2.87,95% CI 1.11-7.45, P=0.030),longer immobilization time (adjust OR=1.13,95% CI 1.07-1.19, P<0.001),and lower international normalized ratio after catheter placement (adjust OR=0.10,95% CI 0.02-0.53, P=0.007) were independent risk factors affecting the occurrence of CRT. Conclusion:The incidence of CRT is relatively high among critically ill children,and medical staff can develop targeted intervention measures by taking relevant risk factors into consideration.
