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首页> 外文期刊>Critical care : >Subclavian central venous catheter-related thrombosis in trauma patients: incidence, risk factors and influence of polyurethane type
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Subclavian central venous catheter-related thrombosis in trauma patients: incidence, risk factors and influence of polyurethane type

机译：锁骨下锁骨下中央静脉导管相关血栓形成：聚氨酯类型的发生率，危险因素和影响

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IntroductionThe incidence of deep venous thrombosis (DVT) related to a central venous catheter varies considerably in ICUs depending on the population included. The aim of this study was to determine subclavian central venous catheter (SCVC)-related DVT risk factors in severely traumatized patients with regard to two kinds of polyurethane catheters.MethodsCritically ill trauma patients needing a SCVC for their usual care were prospectively included in an observational study. Depending on the month of inclusion, patients received one of the two available products in the emergency unit: either an aromatic polyurethane SCVC or an aliphatic polyurethane SCVC. Patients were screened weekly by ultrasound for SCVC-related DVT. Potential risk factors were collected, including history-related, trauma-related and SCVC-related characteristics.ResultsA total of 186 patients were included with a median Injury Severity Sore of 30 and a high rate of severe brain injuries (21% of high intracranial pressure). Incidence of SCVC-related DVT was 37% (95% confidence interval: 26 to 40) in patients or 20/1,000 catheter-days. SCVC-related DVT occurred within 8 days in 65% of cases. There was no significant difference in DVT rates between the aromatic polyurethane and aliphatic polyurethane SCVC groups (38% vs. 36%). SCVC-related DVT independent risk factors were age >30 years, intracranial hypertension, massive transfusion (>10 packed red blood cell units), SCVC tip position in the internal jugular or in the innominate vein, and ipsilateral jugular catheter.ConclusionSCVC-related DVT concerned one-third of these severely traumatized patients and was mostly clinically silent. Incidence did not depend on the type of polyurethane but was related to age >30 years, intracranial hypertension or misplacement of the SCVC. Further studies are needed to assess the cost-effectiveness of routine screening in these patients in whom thromboprophylaxis may be hazardous.
机译：简介与中心静脉导管相关的深静脉血栓形成（DVT）的发生率在ICU中有很大差异，具体取决于所包括的人群。这项研究的目的是针对两种聚氨酯导管，确定重度创伤患者锁骨下中央静脉导管（SCVC）相关的DVT危险因素。方法将观察性重症创伤患者需要SCVC进行常规护理，这些患者被纳入观察性研究研究。根据入院月份的不同，患者会收到急诊科两种可用产品之一：芳族聚氨酯SCVC或脂族聚氨酯SCVC。每周通过超声筛查患者SCVC相关的DVT。收集了包括历史相关，创伤相关和SCVC相关特征在内的潜在危险因素。结果总共包括186名患者，中位严重损伤性疼痛为30，严重脑损伤高发生率（高颅内压的21％） ）。在患者中或在20 / 1,000导管日中，SCVC相关DVT的发生率为37％（95％置信区间：26至40）。 65％的病例在8天内发生了SCVC相关的DVT。芳族聚氨酯和脂族聚氨酯SCVC组之间的DVT率没有显着差异（38％对36％）。与SCVC相关的DVT的独立危险因素为年龄> 30岁，颅内高压，大量输血（> 10个堆积的红细胞单位），颈内或无名静脉中的SCVC尖端位置以及同侧颈静脉导管。这些患者中有三分之一受到严重创伤，临床上大多保持沉默。发病率不取决于聚氨酯的类型，而是与年龄> 30岁，颅内高压或SCVC放错位置有关。需要进一步的研究来评估对血栓预防可能有害的这些患者进行常规筛查的成本效益。

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