Central venous catheter-related deep vein thrombosis in severe inaugural diabetic ketoacidosis: A four case-report and literature review

Abstract

Introduction: Type 1 diabetes (T1D), particularly diabetic ketoacidosis (DKA), is believed to induce a prothrombotic state, mainly due to activation of the coagulation system, platelets, and relative hypofibrinolysis.

Observations and discussion: A central venous catheter (CVC) can be necessary in cases of severe inaugural DKA in the pediatric intensive care unit (PICU). Children with a CVC are at increased risk of thrombosis, particularly before the age of three. Following a literature review and our experience in Toulouse (4 cases) of CVC-related thrombosis, we propose that CVC placement should be avoided as much as possible and alternative venous access should be preferred to minimize the risk of thrombosis.

Conclusion: If CVC placement cannot be avoided, preventive anticoagulation should be considered, but further studies are needed to establish a proper protocol.

Keywords: T1D; central veinous catheter; deep vein thrombosis; type 1 diabetes pediatric.