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Open Access 01-06-2013 | Research

Subclavian central venous catheter-related thrombosis in trauma patients: incidence, risk factors and influence of polyurethane type

Authors: Ariane Gentile, Laurent Petit, Françoise Masson, Vincent Cottenceau, Josseline Bertrand-Barat, Geneviève Freyburger, Catherine Pinaquy, Alain Léger, Jean-François Cochard, François Sztark

Published in: Critical Care | Issue 3/2013

Abstract

Introduction

The incidence of deep venous thrombosis (DVT) related to a central venous catheter varies considerably in ICUs depending on the population included. The aim of this study was to determine subclavian central venous catheter (SCVC)-related DVT risk factors in severely traumatized patients with regard to two kinds of polyurethane catheters.

Methods

Critically ill trauma patients needing a SCVC for their usual care were prospectively included in an observational study. Depending on the month of inclusion, patients received one of the two available products in the emergency unit: either an aromatic polyurethane SCVC or an aliphatic polyurethane SCVC. Patients were screened weekly by ultrasound for SCVC-related DVT. Potential risk factors were collected, including history-related, trauma-related and SCVC-related characteristics.

Results

A total of 186 patients were included with a median Injury Severity Sore of 30 and a high rate of severe brain injuries (21% of high intracranial pressure). Incidence of SCVC-related DVT was 37% (95% confidence interval: 26 to 40) in patients or 20/1,000 catheter-days. SCVC-related DVT occurred within 8 days in 65% of cases. There was no significant difference in DVT rates between the aromatic polyurethane and aliphatic polyurethane SCVC groups (38% vs. 36%). SCVC-related DVT independent risk factors were age >30 years, intracranial hypertension, massive transfusion (>10 packed red blood cell units), SCVC tip position in the internal jugular or in the innominate vein, and ipsilateral jugular catheter.

Conclusion

SCVC-related DVT concerned one-third of these severely traumatized patients and was mostly clinically silent. Incidence did not depend on the type of polyurethane but was related to age >30 years, intracranial hypertension or misplacement of the SCVC. Further studies are needed to assess the cost-effectiveness of routine screening in these patients in whom thromboprophylaxis may be hazardous.

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Title: Subclavian central venous catheter-related thrombosis in trauma patients: incidence, risk factors and influence of polyurethane type
Authors: Ariane Gentile
Laurent Petit
Françoise Masson
Vincent Cottenceau
Josseline Bertrand-Barat
Geneviève Freyburger
Catherine Pinaquy
Alain Léger
Jean-François Cochard
François Sztark
Publication date: 01-06-2013
Publisher: BioMed Central
Published in: Critical Care / Issue 3/2013
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/cc12748

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Subclavian central venous catheter-related thrombosis in trauma patients: incidence, risk factors and influence of polyurethane type

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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