Femoral deep vein thrombosis associated with central venous catheterization

Trottier, Steven; Veremakis, Christopher; OʼBrien, Jacklyn; Auer, Arthur I.

doi:10.1097/00003246-199501000-00011

Cited by 196 publications

(106 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Femoral catheters should be avoided, when possible, because they are associated with a higher risk for deep venous thrombosis than are internal jugular or subclavian catheters [56][57][58][59][60] and because of a presumption that such catheters are more likely to become infected. However, studies in pediatric patients have demonstrated that femoral catheters have a low incidence of mechanical complications and might have an equivalent infection rate to that of nonfemoral catheters [61][62][63].…”

Section: Site Of Catheter Insertionmentioning

confidence: 99%

See 1 more Smart Citation

Guidelines for the prevention of intravascular catheter-related infections

O’Grady¹,

Alexander²,

Dellinger³

et al. 2002

American Journal of Infection Control

635

843

View full text Add to dashboard Cite

These guidelines have been developed for practitioners who insert catheters and for persons responsible for surveillance and control of infections in hospital, outpatient, and home health-care settings. This report was prepared by a working group comprising members from professional organizations representing the disciplines of critical care medicine, infectious diseases, health-care infection control, surgery, anesthesiology, interventional radiology, pulmonary medicine, pediatric medicine, and nursing. The These guidelines are intended to provide evidencebased recommendations for preventing catheter-related infections. Major areas of emphasis include 1) educating and training health-care providers who insert and maintain catheters; 2) using maximal sterile barrier precautions during central venous catheter insertion; 3) using a 2% chlorhexidine preparation for skin antisepsis; 4) avoiding routine replacement of central venous catheters as a strategy to prevent infection; and 5) using antiseptic/antibiotic impregnated short-term central venous catheters if the rate of infection is high despite adherence to other strategies (i.e., education and training, maximal sterile barrier precautions, and 2% chlorhexidine for skin antisepsis). These guidelines also identify performance indicators that can be used locally by health-care institutions or organizations to monitor their success in implementing these evidence-based recommendations.

show abstract

Section: Site Of Catheter Insertionmentioning

confidence: 99%

“…Selection and replacement of intravascular catheters A. Select the catheter, insertion technique, and inser-tion site with the lowest risk for complications (infectious and noninfectious) for the anticipated type and duration of IV therapy [22,55,59,[216][217][218]. Category IA B.…”

Section: Category Ib II Surveillancementioning

confidence: 99%

Guidelines for the prevention of intravascular catheter-related infections

O’Grady¹,

Alexander²,

Dellinger³

et al. 2002

American Journal of Infection Control

635

843

View full text Add to dashboard Cite

show abstract

“…Estimates of femoral CVC-related thrombosis of 23.3% and 25% have been reported in small randomized controlled trials (RCTs) using venographic and ultrasound confirmation, respectively. 7,8 One study found that triple lumen catheters were frequently placed in the femoral site, and that femoral DVT occurred despite prophylaxis with subcutaneous heparin and/or compression stockings. 8 A large recent RCT, involving 289 critically-ill patients assessed by ultrasound, supported that femoral catheterization is associated with a greater risk of infectious [hazard ratio 4.8 (95% Confidence interval (CI) 2.0 -11.9)] and thrombotic [odds ratio (OR) 14.4 (95% CI 3.3 -62.6)] complications compared to subclavian catheterization with 21.6% of patients, with a femoral catheter, experiencing catheter-related thrombosis.…”

Section: Central Venous Catheter-related Thrombosismentioning

confidence: 99%

“…7,8 One study found that triple lumen catheters were frequently placed in the femoral site, and that femoral DVT occurred despite prophylaxis with subcutaneous heparin and/or compression stockings. 8 A large recent RCT, involving 289 critically-ill patients assessed by ultrasound, supported that femoral catheterization is associated with a greater risk of infectious [hazard ratio 4.8 (95% Confidence interval (CI) 2.0 -11.9)] and thrombotic [odds ratio (OR) 14.4 (95% CI 3.3 -62.6)] complications compared to subclavian catheterization with 21.6% of patients, with a femoral catheter, experiencing catheter-related thrombosis. 9 These estimates are supported by a prospective observational study of 140 critically-ill patients, 124 of whom were evaluated with ultrasound, noting 12 CVC-related femoral DVTs.…”

Section: Central Venous Catheter-related Thrombosismentioning

confidence: 99%

A critical review of thromboembolic complications associated with central venous catheters

Burns

McLaren

2008

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Purpose: Central venous catheters (CVC) are commonly used in critical care. While thrombosis is a well-recognized and frequent complication associated with their use, CVC-related thromboembolic complications, including pulmonary embolism (PE) and right heart thromboembolism (RHTE), occur less frequently and often evade diagnosis. Little information exists to guide clinicians in the diagnosis and management of CVC-related thromboembolic complications. Source:We critically review and synthesize the literature highlighting the incidence of CVC-related thrombosis. We highlight the risk for developing thromboembolic complications and provide approaches to diagnosing and managing RHTE. Principle findings:The incidence of CVC-related thrombosis varies depending on patient, site, instrument, and infusaterelated factors. Central venous catheters-related thrombosis represents an important source of morbidity and mortality for affected patients. Pulmonary embolism occurs in approximately 15% of patients with CVC-related upper extremity deep venous thrombosis (UEDVT). More frequent use of transesophageal echocardiography, in patients with suspected and confirmed PE, has resulted in increased detection of RHTE. While it is recognized that the occurrence of RHTE, in association with PE, increases mortality, the optimal strategy for their management has not been established in a clinical trial. Conclusion:Central venous catheter-related thrombosis occurs frequently and represents an important source of morbidity and mortality for affected patients. Our review supports that surgery and thrombolysis have both been demonstrated to enhance survival in patients with RHTE and PE. However, important patient, clot, and institutional considerations mandate that treatment for patients with RHTE and PE be individualized.

show abstract

“…These accesses are used only when there are constraints to use the standard venous accesses. There could be higher complication rate for these alternative accesses in the long term usage [2,3]. Femoral vein was chosen as internal jugular or subclavian vein access could not be used.…”

Section: Discussionmentioning

confidence: 99%