• Chunshuang Wu, Mao Zhang, Wenjie Gu, Caimu Wang, Xudong Zheng, Junfeng Zhang, Xingwen Zhang, Shijin Lv, Xuwei He, Xiaoyuan Shen, Wenlong Wei, Guotao Wang, Yingru Lu, Qingli Chen, Renfei Shan, Lingcong Wang, Feng Wu, Ting Shen, Xuebo Shao, Jiming Cai, Fuzheng Tao, Haiying Cai, Qin Lu, and Study Group of Central Venous Catheter-related Thrombosis.
• Department of Emergency Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
• Intensive Care Med. 2023 Apr 1; 49 (4): 401410401-410.

PurposeCentral venous catheter (CVC)-related thrombosis (CRT) is a known complication in critically ill patients. However, its clinical significance remains unclear. The objective of the study was to evaluate the occurrence and evolution of CRT from CVC insertion to removal.MethodsA prospective multicenter study was conducted in 28 intensive care units (ICUs). Duplex ultrasound was performed daily from CVC insertion until at least 3 days after CVC removal or before patient discharge from the ICU to detect CRT and to follow its progression. CRT diameter and length were measured and diameter > 7 mm was considered extensive.ResultsThe study included 1262 patients. The incidence of CRT was 16.9% (95% confidence interval 14.8-18.9%). CRT was most commonly found in the internal jugular vein. The median time from CVC insertion to CRT onset was 4 (2-7) days, and 12% of CRTs occurred on the first day and 82% within 7 days of CVC insertion. CRT diameters > 5 mm and > 7 mm were found in 48% and 30% of thromboses. Over a 7-day follow-up, CRT diameter remained stable when the CVC was in place, whereas it gradually decreased after CVC removal. The ICU length of stay was longer in patients with CRT than in those without CRT, and the mortality was not different.ConclusionCRT is a frequent complication. It can occur as soon as the CVC is placed and mostly during the first week following catheterization. Half of the thromboses are small but one-third are extensive. They are often non-progressive and may be resolved after CVC removal.© 2023. Springer-Verlag GmbH Germany, part of Springer Nature.

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