Área de Neonatología, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Ciudad Autónoma de Buenos Aires, Argentina.
Servicio de Imágenes, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Ciudad Autónoma de Buenos Aires, Argentina.
Arch Argent Pediatr. 2021 Feb;119(1):32-38. doi: 10.5546/aap.2021.eng.32.
In neonatology, more than 90 % of deep vein thromboses are related to catheter use. The objective of this study was to determine the incidence and risk factors associated with central venous catheter-related deep vein thrombosis.
Observational and analytical study conducted in a prospective cohort. All central venous catheters were included using consecutive, non-random sampling. The screening protocol included a daily clinical examination and a Doppler ultrasound (7-10 days after insertion and/or 72 h after removal). Follow-up: from catheter insertion to catheter removal, death or patient counter-referral. The incidence density rate per 1000 catheter-days was estimated with its corresponding 95 % confidence intervals (CIs), and risk factors, using Cox multivariate analysis.
Thrombosis was identified in 22/264 catheters. The incidence density rate of thrombosis was 5.33 ‰ catheter-days (95 % CI: 3.34-8.07). Cardiovascular surgery and and the use of central catheters others than peripherally inserted ones, were independent risk factors for thrombosis (hazard ratio: 3.8 [95 % CI: 1.6-9] and 2.75 [95 % CI: 1.17-6.45]).
The incidence of central venous catheter-related deep vein thrombosis was 5.33 per 1000 catheter-days. A history of cardiovascular surgical procedures and and the use of central catheters others than peripherally inserted ones, were associated with a higher risk of this complication.
在新生儿科，超过 90%的深静脉血栓与导管使用有关。本研究旨在确定与中心静脉导管相关的深静脉血栓形成的发生率和相关危险因素。
这是一项前瞻性队列观察性分析研究。所有中心静脉导管均采用连续、非随机抽样法纳入。筛查方案包括每日临床检查和多普勒超声（插入后 7-10 天和/或移除后 72 小时）。随访：从导管插入到导管移除、死亡或患者拒绝。使用 Cox 多变量分析估计每 1000 导管日的发生率密度率及其相应的 95%置信区间（CI）和危险因素。
在 264 根导管中发现了 22 根血栓。血栓形成的发生率密度率为 5.33‰导管日（95%CI：3.34-8.07）。心血管手术和使用外周插入式以外的中心导管是血栓形成的独立危险因素（危险比：3.8[95%CI：1.6-9]和 2.75[95%CI：1.17-6.45]）。
中心静脉导管相关深静脉血栓形成的发生率为每 1000 导管日 5.33 例。心血管手术史和使用外周插入式以外的中心导管与该并发症风险增加相关。
