Chest
Clinical Investigations in Critical CareDeep Venous Thrombosis Caused by Femoral Venous Catheters in Critically Ill Adult Patients
Section snippets
Materials and Methods
The study was performed in a 16-bed, mixed medical and surgical ICU at a university teaching hospital. Approval for the study was obtained from the Clinical Research Ethics Committee of the Chinese University of Hong Kong. Informed consent was obtained from a senior relative when the patient's condition precluded provision of his or her own consent. All adult patients undergoing femoral-route central venous catheterization between January 1996 and February 1998 were recruited for the study. The
Results
Over a 25-month period, 140 patients were entered into the study. Sixteen patients were withdrawn after entry into the study: 1 patient was found to be lupus anticoagulant–positive (this patient developed a line-related DVT); 6 patients survived < 24 h after insertion of the femoral catheter; 3 patients had attempted cannulation of the contralateral vein; and 6 patients required cannulation of the contralateral femoral vein before the follow-up period was complete. Thus, 124 patients were
Discussion
This prospective study demonstrates a consistent and clinically important increase in iliofemoral DVT following the use of femoral venous catheters. Patients with femoral lines in situ can expect to have, on average, a sixfold increased risk of iliofemoral DVT. Despite this being the largest study to date, the confidence intervals are wide and the risk may be as low as twofold or as high as 20-fold the baseline risk of iliofemoral DVT in noncatheterized limbs. Other studies performed to
References (32)
- et al.
Central venous catheterization in the critically ill patient
Crit Care Clin
(1992) - et al.
Emergency intravenous access through the femoral vein
Ann Emerg Med
(1984) - et al.
Comparison of intrathoracic and intra-abdominal measurements of central venous pressure
Lancet
(1996) - et al.
Infectious and mechanical complications of central venous catheters placed by percutaneous venipuncture and over guidewires
Crit Care Med
(1992) Central venous catheters
- et al.
The percutaneous common femoral vein catheter in critically injured patients
J Trauma
(1988) - et al.
Vascular access through the femoral vessels: indications and complications
J Burn Care Rehabil
(1986) - et al.
Central venous catheter insertion by femoral vein: safety and effectiveness for the pediatric patient
Pediatrics
(1986) - et al.
Use of femoral venous catheters in critically ill adults: prospective study
Crit Care Med
(1991) Femoral catheters
Ann Surg
(1957)
Complications following use of indwelling catheters of inferior vena cava
JAMA
The jury on femoral vein catheterization is still out
Crit Care Med
A prospective evaluation of the use of femoral venous catheters in critically ill adults
Crit Care Med
Lower extremity deep vein thrombosis: a prospective randomized, controlled trial in comatose or sedated patients undergoing femoral vein catheterization
Crit Care Med
A comparison of central venous pressure and common iliac venous pressure in critically ill mechanically ventilated patients
Crit Care Med
Catheter replacement of the needle in percutaneous arteriography
Acta Radiol
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Currently at St. Mary's Hospital, London, UK