Thrombosis of the internal jugular vein after CVC placement
摘要
Central venous catheters (CVC) in the internal jugular vein are established in perioperative care; however, the incidence of catheter-associated thrombosis (CAT) and catheter-related thromboembolic complications (CTEC) remains insufficiently studied.
ObjectiveThis study aimed to assess the incidence and characteristics of CAT with a focus on differences between geriatric and nongeriatric patients. Among the guiding questions were do the risk and incidence of CAT fundamentally differ between geriatric and nongeriatric patients and is the catheter dwell time associated with increased thrombotic risk?
MethodsIn this 6‑month prospective study, consecutive patients from orthopedic, trauma and vascular surgery with CVC in the internal jugular vein were examined. Patients were categorized into a geriatric group and a non-geriatric group. Sonographic assessments were performed initially and weekly during which CATs were measured and analyzed.
ResultsOut of 117 patients 90 (77%) developed CAT. No significant differences were found between geriatric (78.9%) and nongeriatric patients (76.7%, p = 0.767). The mean thrombus size was similar. A significant correlation existed between catheter dwell time and CAT incidence.
DiscussionThe incidence of CAT was high regardless of the geriatric status. Catheter dwell time emerged as a relevant risk factor. Standardized and systematic sonographic monitoring and critical CVC indications should be considered.