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. 2022 Jan;20(1):133-137.
doi: 10.1111/jth.15548. Epub 2021 Oct 19.

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

Julie Jaffray  1   2 , Lisa Baumann Kreuziger  3 , Brian Branchford  3 , Choo Phei Wee  1 , E Vincent S Faustino  4 , Neil A Zakai  5 , Stacy E Croteau  6   7 , Michael Silvey  8 , John H Fargo  9 , James D Cooper  10 , Nihal Bakeer  11 , Amy Stillings  1 , Emily Krava  1 , Guy Young  1   2 , Neil A Goldenberg  12   13
Affiliations
Free article

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

Julie Jaffray et al. J Thromb Haemost. 2022 Jan.
Free article

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 diagnosed <3 days after CVC removal. Subjects were excluded if the CRT was due to a failed CVC insertion. Subjects were divided into three groups: those with CVC removal without anticoagulation, those with CVC removal <48 h after starting anticoagulation, 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 occurred <48 h after initiation of anticoagulation.

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.

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

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References

REFERENCES

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