DOI: 10.1097/01.ruq.0000228208.52123.e4
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Issn Print: 0894-8771
Publication Date: 2006/09/01
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Excerpt
Gupta et al. Pediatr Blood Cancer. 2006
This study evaluated the applicability of ultrasound to evaluate the morphology of the upper extremity venous system, with attention to venous stenoses and occlusions, in children who had had multiple central lines placed.
A total of 50 cases (47 patients), in which children who had had multiple (ie, more than 1 line on either side) tunneled central venous catheters placed, underwent a detailed upper extremity Doppler ultrasound mapping and evaluation. Findings were correlated with clinical findings, including the patient's primary disease and the catheter type, duration of previous central venous access, and history of a line infection, if present.
This study found that venous compromise (thrombosis or stenosis) was not predictable based on the patient's age, sex, primary disease, catheter size, duration of central venous access, or an association with infection.
As patients with venous compromise can be totally asymptomatic and, the authors note in the Discussion, asymptomatic central venous thromboses can occur with an incidence of up to 85%; imaging studies such as Doppler ultrasound to fully evaluate the central venous system before central line placement may be useful.
