Symptomatic pulmonary embolus after catheter removal in children with catheter related thrombosis: A report from the CHAT Consortium.

Document Type

Article

Publication Date

1-2022

Identifier

DOI: 10.1111/jth.15548

Abstract

BACKGROUND: Appropriate timing of central venous catheter (CVC) removal, in relation to start of anticoagulation, in children after the diagnosis of a CVC-related thrombosis (CRT) is not well established.

OBJECTIVES: This retrospective cohort study evaluated the incidence of symptomatic pulmonary embolism (PE) after CVC removal using data from the multi-institutional Children's Hospital-Acquired Thrombosis (CHAT) Consortium Registry.

PATIENTS/METHODS: The CHAT Registry consists of data from children aged 0-21 years with a hospital-acquired venous thromboembolism. Eligible subjects were those with CRT diagnosedanticoagulation, those with CVC removalanticoagulation, and those with CVC removal ≥48 h after starting anticoagulation.

RESULTS: A total of 687 CRT events from 663 subjects were included. A majority of CRT events were in subjects with peripherally inserted central catheters (62.3%, n = 428). For the 611 CRT events in which the CVC was removed, there was only one case of symptomatic PE (0.16%), which occurredanticoagulation.

CONCLUSIONS: While current guidelines suggest anticoagulation before CVC removal in the setting of a CRT to prevent embolization, CVC removal is not associated with symptomatic PE regardless of duration of anticoagulation before CVC removal.

Journal Title

Journal of thrombosis and haemostasis : JTH

Volume

20

Issue

1

First Page

133

Last Page

137

Keywords

anticoagulants; central venous catheters; deep vein thrombosis; pediatrics; pulmonary embolism; venous thromboembolism

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