Catheter-Related Venous Thrombosis in Hospitalized Pediatric Patients with Inflammatory Bowel Disease: Incidence, Characteristics, and Role of Anticoagulant Thromboprophylaxis with Enoxaparin.

Abstract

OBJECTIVE:

To describe the incidence and characteristics of central venous catheter (CVC)-related thrombosis in hospitalized pediatric patients with active inflammatory bowel disease (IBD) and report the potential usefulness of anticoagulant thromboprophylaxis (AT).

STUDY DESIGN:

We conducted a retrospective study of patients who were admitted to our children's hospital in the last 2 years with active IBD and required a CVC and identified all patients with an objectively confirmed symptomatic CVC-related thrombosis. To assess the usefulness of a recently implemented institutional AT protocol, we compared the frequency of CVC-related thrombosis, nadir hemoglobin, and red blood cell transfusion requirements in patients who received AT with those who did not during the study period.

RESULTS:

A total of 40 patients with IBD who required 47 consecutive hospitalizations were included. AT was administered during 24 of 47 hospitalizations (51%). Patients who received AT were similar to those who did not receive AT with regard to demographics, IBD phenotypes, extent of colonic involvement, and thrombotic risk factors. CVC-related thrombosis occurred in 5 of 23 hospitalizations (22%) in which AT was withheld compared with 0 of 24 hospitalizations (0%) in which patients received AT (P = .02). The red blood cell transfusion requirements and nadir hemoglobin were not significantly different between the 2 groups.

CONCLUSIONS:

We observed a high incidence of CVC-related thrombosis in hospitalized children with IBD. Administration of AT in our population was associated with significant reduction in CVC-related thrombosis without evidence of increased bleeding.

• Authors: Carrie E Diamond, Carole Hennessey, Jennifer Meldau, Christine J Guelcher, Michael F Guerrera, Laurie S Conklin, Karun V Sharma, Yaser A Diab
• Journal: The Journal of pediatrics (J Pediatr) Vol. 198 Pg. 53-59 (07 2018) ISSN: 1097-6833 [Electronic] United States
• PMID: 29628414 (Publication Type: Journal Article)
• Copyright: Copyright © 2018 Elsevier Inc. All rights reserved.

Chemical References

• Anticoagulants
• Enoxaparin

Topics

• Adolescent
• Anticoagulants (therapeutic use)
• Catheterization, Central Venous (adverse effects)
• Central Venous Catheters (adverse effects)
• Child
• Enoxaparin (therapeutic use)
• Female
• Hospitalization
• Humans
• Incidence
• Inflammatory Bowel Diseases (therapy)
• Male
• Retrospective Studies
• Venous Thrombosis (epidemiology, prevention & control)