Asymptomatic Catheter-Related Thrombosis: Ignore or Address?

Catheter-related thrombosis (CRT) is a concerning complication for ICU patients. Traditionally, the focus has been on symptomatic CRTs, but this study sheds light on the incidence and risk factors of asymptomatic CRTs in a non-oncologic ICU population. We will be discussing a paper on Asymptomatic Catheter-Related Thrombosis.

This was a single-center prospective observational study. Patients were monitored daily via ultrasound to detect CRT. The study aimed to determine the incidence rate, cumulative incidence, and risk factors for asymptomatic CRTs.

Out of 203 patients, 25% developed CRT, with 14% of the 375 catheters inserted showing CRT. Interestingly, 88% of these CRTs were partial thrombosis, and all remained asymptomatic. Key findings include obesity and ECMO support as patient-related protective factors. On the other hand, the internal jugular vein had a higher CRT incidence rate compared to other sites, and pulmonary artery catheters and left-side cannulation were identified as catheter-related risk factors.

The study’s implications are significant. It suggests a need to reassess our understanding of CRT risk factors. The fact that obesity and ECMO support appeared as protective factors is intriguing and warrants further research. Also, the preference for the internal jugular vein and the risks associated with certain catheter types like pulmonary artery catheters offer practical insights for ICU practices.

CRTs in ICU patients are more common than previously thought, especially the asymptomatic ones. This study challenges some traditional beliefs and opens the door for more research on CRT management and prevention strategies. What do you think we should do regarding Asymptomatic Catheter-Related Thrombosis?

Citation for Asymptomatic Catheter-Related Thrombosis

Abbruzzese C, Guzzardella A, Consonni D, Turconi G, Bonetti C, Brioni M, Panigada M, Grasselli G. Incidence of asymptomatic catheter-related thrombosis in intensive care unit patients: a prospective cohort study. Ann Intensive Care. 2023 Oct 19;13(1):106. doi: 10.1186/s13613-023-01206-w. PMID: 37858003; PMCID: PMC10587047.
Link to Article

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