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Catheter-related thrombosis after cardiac surgery in patients with both central venous and pulmonary artery catheters inserted into the right internal jugular vein: a single-center, prospective, observational study.

Abstract
Central venous catheters (CVCs) and pulmonary artery catheters (PACs) are widely used in intensive care and perioperative management. The detection and prevention of catheter-related thrombosis (CRT) are important because CRT is a complication of catheter use and can cause pulmonary embolism and bloodstream infection. Currently, there is no evidence for CRT in patients using both CVC and PAC. We conducted a single-center, prospective, observational study to identify the incidence, timing, and risk factors for CRT in patients undergoing cardiovascular surgery and using a combination of CVC and PAC through the right internal jugular vein (RIJV). Out of 50 patients, CRT was observed using ultrasonography in 39 patients (78%), and the median time of CRT formation was 1 day (interquartile range: 1-1.5) after catheter insertion. The mean duration of PAC placement was 3 days (interquartile range: 2-5), and the maximum diameter of CRT was 12 mm (interquartile range: 10-15). In short-axis images, CRT occupied more than half of the cross-sectional area of the RIJV in five patients (10%), and CRT completely occluded the RIJV in one patient (2%). Platelet count, duration of PAC placement, and intraoperative bleeding amount were found to be high-risk indicators of CRT. In conclusion, patients who underwent cardiovascular surgery and using both CVC and PAC had a high incidence of CRT. Avoiding unnecessary PAC placement and early removal of catheters in patients at high risk of developing CRT may prevent the development of CRT.
AuthorsMasafumi Idei, Yusuke Seino, Nobuo Sato, Yumi Saishu, Shunsaku Goto, Motoki Namekawa, Shota Moriwaki, Junya Ishikawa, Daigo Kamei, Masashi Nakagawa, Shingo Ichiba, Takeshi Nomura
JournalHeart and vessels (Heart Vessels) Vol. 37 Issue 4 Pg. 691-696 (Apr 2022) ISSN: 1615-2573 [Electronic] Japan
PMID34618188 (Publication Type: Journal Article, Observational Study)
Copyright© 2021. Springer Japan KK, part of Springer Nature.
Topics
  • Cardiac Surgical Procedures (adverse effects)
  • Catheterization, Central Venous (adverse effects)
  • Central Venous Catheters (adverse effects)
  • Humans
  • Jugular Veins (diagnostic imaging)
  • Prospective Studies
  • Pulmonary Artery (diagnostic imaging)
  • Thrombosis (etiology)

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