(370) Risk Factors for Central Line-Associated Venous Thrombosis in Neonates and Infants Admitted to CICU

Introduction: It is well established that insertion of central venous lines (CVL) augments the development of deep vein thrombosis (DVT). Neonates and infants with congenital heart disease who frequently require central access are at an increased risk for development of DVTs, though literature regarding DVT and central venous catheter (CVC)-associated DVT in this population is limited. This study aims to describe and report the prevalence and risk factors for DVT in neonates and infants admitted to the pediatric cardiac intensive care unit (PCICU).

Methods: A retrospective chart review of all patients under one year with congenital heart disease (CHD) admitted to the PCICU at Children’s of Mississippi was performed. The study encompassed a five-year period from May 1st, 2017, to April 30, 2022. Demographics, cardiac surgical and catheterization procedures, and CVL related information was collected. Statistical analysis was performed using JASP software using appropriate chi-squared and t-tests.

Results: Of the 460 admissions to the PCICU during our study period, 328 patients met inclusion criteria. In this patient cohort, 607 central lines were placed. Central line related thrombus occurred in 23 patients (7.5%). Increased hospitalization days, number of central line days, and number of lines were associated with increased likelihood for thrombus (all P < 0.05). Younger age and lower admission weight were strongly associated with higher incidence of thrombus. Having a surgical procedure or cardiac catheterization did not increase risk of thromboembolic event but mean coronary bypass time was associated with increased incidence of thrombus (p=0.009).

Conclusions: In pediatric patients with CHD, our study identifies multiple risk factors that increase the risk for thrombus development associated with central lines, further emphasizing the need for protocolized thrombo-prophylaxis in these patients to decrease the associated morbidity and mortality. Preventable causes of morbidity and mortality are of crucial importance when considering the CHD population, as advancements in surgical techniques and medical therapies have improved survival rates.