Impact of catheter-to-vein diameter ratio on thrombosis in pediatric central venous catheterization


KAHVECİ F., ÇELİK N. A., Uçmak H., Gurbanov A., COŞKUN M. K., Özen H., ...Daha Fazla

Frontiers in Pediatrics, cilt.13, 2025 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 13
  • Basım Tarihi: 2025
  • Doi Numarası: 10.3389/fped.2025.1631247
  • Dergi Adı: Frontiers in Pediatrics
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, Directory of Open Access Journals
  • Anahtar Kelimeler: catheter vessel diameter ratio, central venous catheter (CVC), pediatrics, PICU (pediatric intensive care unit), thrombosis
  • Ankara Üniversitesi Adresli: Evet

Özet

Objective: Catheter-related thrombosis is a common complication of central venous catheter insertion. As the use of central venous catheters increases in pediatric critical care settings, catheter-related thrombosis is becoming more common among patients who typically have multiple risk factors for thromboembolism. We aimed to investigate impact of catheter-to-vein diameter ratio on thrombosis in pediatric central venous catheterization. Methods: Single-center, prospective study. In our study, thrombosis risk factors and patient-related factors were excluded. Results: A total of 50 patients were included in our study. Thrombosis was observed in 34% of the patients. When comparing thrombotic and nonthrombotic patients, factors such as a low aPTT value, dialysis catheter use, certain mutations that may cause thrombosis, a high catheter-to-blood vessel diameter ratio (C/VR), and a high catheter area-to-blood vessel area ratio (C/VA) are associated with an increased risk of thrombosis. In backwards logistic regression analysis of thrombosis risk, older age, a decreased catheter area, a high C/VA ratio, and the use of dialysis catheters contributed to an increased risk of thrombosis. Patients with dialysis catheters have a 64.9 times greater risk of thrombosis than do those with central venous catheters. The C/VR, with a cut-off value of 0.197, and the C/VA, with a cut-off value of 0.088, are effective indicators in ROC analysis for thrombosis. Conclusion: In conclusion, selecting a catheter with a diameter-to-vessel diameter ratio of less than 1:5 in normovolaemic paediatric patients should be considered as a strategy to reduce the risk of catheter-related thrombosis.