Femoral central venous catheter-associated deep venous thrombosis in children with diabetic ketoacidosis

OBJECTIVE

To describe the incidence of clinical deep venous thrombosis associated with femoral central venous catheters (CVC-DVT) in children with diabetic ketoacidosis (DKA).

DESIGN

Retrospective case-matched control series.

SETTING

Pediatric intensive care units of two university-affiliated hospitals.

PATIENTS

All eight pediatric DKA patients with femoral central venous catheters between 1998 and 2001, and 16 age-matched control patients with femoral central venous catheters and circulatory shock.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

The records of all children with DKA and the control patients were reviewed. CVC-DVT was defined as persistent ipsilateral leg swelling after removal of a femoral central venous catheter. Control patients with coagulopathies, thrombocytopenia, cancer, and hyperglycemia were excluded. Four of eight patients with DKA developed CVC-DVT compared with none of the 16 control patients (p = .007, Fisher's exact test). All four patients with DKA and CVC-DVT were <3 yrs old. Doppler ultrasound examination was performed on three of the four patients with clinical CVC-DVT, confirming the diagnosis in each case.

CONCLUSIONS

This study suggests that young children with DKA have an increased incidence of clinical DVT associated with the placement of femoral central venous catheters.