Central Venous Line-Related Thrombosis in Children

Abstract

Central venous lines are used in critically ill children and in children with chronic conditions for the administration of intravenous therapy, such as fluids, medications, total parenteral nutrition and blood products. Although the use of central venous lines has greatly improved the quality of care in these children, these catheters may cause serious mechanical, infectious and thrombotic complications. The reported frequency of catheter thrombosis in children is low as 5% in studies including only symptomatic cases and high as 50% in studies where patients are systematically screened for catheter-related thrombosis. The risk factors for catheter-related thrombosis in children are associated with the methods used for catheter insertion and with individual patient characteristics, underlying diagnosis and treatment. The management of catheter-related thrombosis is largely dependent on the requirement of the catheter. If no longer required or nonfunctioning the catheter should be removed. If access is still required and the catheter is functioning, treatment with anticoagulation is recommended in the absence of contraindications. The management of radiographically detected asymptomatic thrombosis in children is less clear. Clinical studies of prophylaxis for catheter-related thrombosis are inconclusive and no definitive recommendations for prophylaxis in adults or in children with central venous thrombosis can be made. Properly designed studies are needed to assess the role of prophylactic anticoagulation for preventing catheter-related thrombosis.

Epidemiology and prevention of catheter‐related thrombosis in patients with cancer

“…This review will summarize the definition, risk factors and epidemiology of CRT in cancer patients, and review the evidence on prevention. It will focus largely on published data in adults, as CRT has a different natural history and a different prognosis in neonates and children [3]. Thrombotic complications of hemodialysis and apheresis catheters are not discussed.…”

Complications of central venous stenosis due to permanent central venous catheters in children on hemodialysis

“…Previous reports are rare and almost exclusively in adults patients. However, venous obstruction is relatively common in pediatric patients with CVCs (unpublished data, [2]) and complications should be looked for.…”

What is the value of magnetic resonance venography in children before renal transplantation?

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