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脓毒性休克患者静脉血栓栓塞风险评估:中心静脉导管单腔与双腔置管比较。

Risk Assessment of Venous Thromboembolism among Septic Shock Patients: Single versus Concurrent Insertion of Central Venous Catheters.

机构信息

Department of Surgery, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.

Department of Anesthesia and Intensive Care, Emergency County Hospital, 320210 Resita, Romania.

出版信息

Medicina (Kaunas). 2024 May 9;60(5):785. doi: 10.3390/medicina60050785.

DOI:10.3390/medicina60050785
PMID:38792968
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11123159/
Abstract

Thrombosis is a serious complication experienced by some hospitalized patients. While concurrent placement of two catheters (CVCs) in the same central vein offers several benefits in clinical settings, we aimed to investigate the role of this procedure in relation to the risk of thrombosis. Over a two-year retrospective analysis, we examined 114 patients with septic shock caused by a pulmonary infection, who underwent the insertion of one or more central lines into a central vein during their ICU stay. Logistic regression models were employed to assess the correlation between the Caprini risk score, the placement of two CVCs in the same vein, COVID-19 infection and the risk of venous thromboembolism (VTE). In total, 53% of the patients underwent the concurrent insertion of two CVCs. The placement of two CVCs in the same vein appears to elevate the VTE risk by 2.5 times (95% CI: 1.03-6.12). Logistic regression analysis indicated that hemodialysis catheters amplify the VTE risk by nearly five times, even when accounting for a series of factors (95% CI: 1.86-12.31). Our study suggests that the elevated risk of VTE is likely associated with the insertion of the hemodialysis catheters rather than solely the presence of two concurrent catheters.

摘要

血栓形成是一些住院患者经历的严重并发症。虽然在同一中心静脉内同时放置两个导管(CVC)在临床环境中具有多种益处,但我们旨在研究该程序与血栓形成风险的关系。在为期两年的回顾性分析中,我们检查了 114 名因肺部感染引起的感染性休克患者,他们在 ICU 期间将一条或多条中央线插入中央静脉。使用逻辑回归模型评估 Caprini 风险评分、同一静脉内放置两个 CVC、COVID-19 感染与静脉血栓栓塞症(VTE)风险之间的相关性。总共有 53%的患者同时插入了两个 CVC。同一静脉内放置两个 CVC 似乎使 VTE 风险增加 2.5 倍(95%CI:1.03-6.12)。逻辑回归分析表明,即使考虑到一系列因素,血液透析导管也会使 VTE 风险增加近五倍(95%CI:1.86-12.31)。我们的研究表明,VTE 风险的增加可能与血液透析导管的插入有关,而不仅仅是两个同时存在的导管。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d56a/11123159/52ac3030e7e8/medicina-60-00785-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d56a/11123159/41cd8a2111c8/medicina-60-00785-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d56a/11123159/a92132e07d44/medicina-60-00785-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d56a/11123159/0d8d90ccc675/medicina-60-00785-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d56a/11123159/52ac3030e7e8/medicina-60-00785-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d56a/11123159/41cd8a2111c8/medicina-60-00785-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d56a/11123159/a92132e07d44/medicina-60-00785-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d56a/11123159/0d8d90ccc675/medicina-60-00785-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d56a/11123159/52ac3030e7e8/medicina-60-00785-g004.jpg

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