Periferik Venöz Katater Uygulanan Hastalarda Üst Ekstremite Ven Trombozunun Doppler Ultrasonografi ile Değerlendirilmesi
Öz
Amaç: Periferik venöz kataterler (PVK), damar duvar hasarı nedeniyle venöz tromboz riskini artırabilir. Çalışmanın amacı, PVK’lerin çoğu üst ekstremitelere uygulandığı için, PVK'ya bağlı üst ekstremite venöz tromboz (ÜEVT) vakalarını belirlemektir.
Yöntem: Bir aylık süreçte göğüs hastalıkları kliniğinde yatan hastalardan PVK'sı olan veya başvurusundan önce hastane yatışında PVK öyküsü olan 69 hasta bu prospektif çalışmaya dahil edildi. PVK’ya bağlı trombüs oluşumunu değerlendirmek için tüm hastalara üst ekstremite Doppler, kompresyon ultrasonografi (USG) tetkiki yapıldı. ÜEVT olan olgular grup 1, ÜEVT olmayan olgular ise grup 2 olarak değerlendirildi. Demografik parametreler ve intravenöz tedaviler (İV) gruplar arasında karşılaştırıldı.
Bulgular: Altmış dokuz hastanın 26'sında (%37,7) Doppler USG ile ÜEVT tanısı kondu. On hastada (%14,5) alt ekstremite ven trombozu tespit edildi. Yirmi altı hastanın 14'ünde (%53,8) sefalik vende ve dört hastada (%15,4) bazilik vende ÜEVT görüldü. Derin ÜEVT iki olguda (%2,9) aksiller ve brakiyal venlerde; yüzeyel ÜEVT 24 olguda (%34,8) izlendi. Seftriakson, sefoperazon / sulbaktam ve esomeprazol, ÜEVT ile en çok ilişkili İV tedavilerdi. Sadece kan almak için PVK uygulanan beş hastada ÜEVT izlendi.
Sonuç: Çalışmamızın sonuçları, hastaların yaklaşık 1/3'ünde Doppler USG incelemesi ile ÜEVT tespit edildiği için PVK'nın ÜEVT için bir risk faktörü olduğunu göstermiştir. PVK'ya gereksinim kalmadığında veya intravenöz tedavi ihtiyacı azaldığında, oral tedavi planlanmalı ve PVK çıkarılmalıdır. ÜEVT'den kaçınmak için PVK'nın çıkarılması gerekli görünmektedir.
Anahtar Kelimeler
Periferik venöz katater üst ekstremite ven trombozu Doppler ultrasonografi intravenöz tedavi
Destekleyen Kurum
Yok
Teşekkür
Yok
Kaynakça
- Linnemann B, Lindhoff E. Risk factors, management and primary prevention of thrombotic complications related to the use of central venous catheters. Vasa. 2012;41(5):319-332. doi:10.1024/0301-1526/a000217.
- Blom JW, Doggen CJ, Osanto S, Rosendaal FR. Old and new risk factors for upper extremity deep venous thrombosis. J Thromb and Haemost. 2005;3(11):2471-2478. doi:10.1111/j.1538-7836.2005.01625x.
- Engelberger RP, Kucher N. Management of Deep Vein Thrombosis of the Upper Extremity. Circulation. 2012;126(6):768-773. doi:10.1161/circulationaha.111.051276.
- Grant JD, Stevens SM, Woller SC, et al. Diagnosis and management of upper extremity deep-vein thrombosis in adults. Thromb Haemost. 2012;108(6):1097-1108. doi:10.1160/th12-05-0352.
- Kalipatnapu S, Premkumar P, Selvaraj D, Agarwal S. Superficial venous thrombosis: Single-center experience and current recommendations. Indian J Vasc Endovasc Surg. 2019;6(4):235-241. doi:10.4103/ijves.ijves_25_19.
- Zingg W, Pittet D. Peripheral venous catheters: an under-evaluated problem. Int J Antimicrob Agents. 2009;34 Suppl 4:38-42. doi:10.1016/S0924-8579(09)70565-5.
- Piper R, Carr PJ, Kelsey LJ, et al. The mechanistic causes of peripheral intravenous catheter failure based on a parametric computational study. Sci Rep. 2018;8(1):3441. doi:10.1038/s41598-018-21617-1.
- Cicolini G, Manzoli L, Simonetti V, et al. Phlebitis risk varies by peripheral venous catheter site and increases after 96 hours: a large multi-center prospective study. J Adv Nurs. 2014;70(11):2539-2549. doi:10.1111/jan.12403.
- Heil J, Miesbach W, Vogl T, Bechstein WO, Reinisch A. Deep vein thrombosis of the upper extremity. Dtsch Arztebl Int. 2017;114(14):244-249. doi:10.3238/arztebl.2017.0244.
- Kilic H, Senturk A, Hasanoglu HC, et al. Incidence of upper extremity thrombosis in pulmonary thromboembolism. J Cardiovasc Surg. 2014;2(2):17-21. doi:10.5455/jcvs.2014212.
- Tesselaar ME, Ouwerkerk J, Nooy MA, Rosendaal FR, Osanto S. Risk factors for catheter-related thrombosis in cancer patients. Eur J Cancer. 2004;40(15):2253-2259. doi:10.1016/j.ejca.2004.06.023.
- Joffe HV, Kucher N, Tapson VF, Goldhaber SZ. Upper-extremity deep vein thrombosis: a prospective registry of 592 patients. Circulation. 2004;110(12):1605-1611. doi:10.1161/01.cir.0000142289.94369.d7.
- Rooden CJ, Tesselaar ME, Osanto S, Rosendaal FR, Huisman MV. Deep vein thrombosis associated with central venous catheters – a review. J Thromb Haemost. 2005;3(11):2409-2419. doi:10.1111/j.1538-7836.2005.01398.x.
- Goltz JP, Scholl A, Ritter CO, et al. Peripherally Placed Totally Implantable Venous-access Port Systems of the Forearm: Clinical Experience in 763 Consecutive Patients. Cardiovasc Intervent Radiol. 2010;33(6):1159-1167. doi:10.1007/s00270-010-9854-6.
- Kearon C, Akl EA, Comerota AJ, et al. Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl):e419S-e496S. doi:10.1378/chest.11-2301.
- Linnemann B, Meister F, Schwonberg J, et al. Hereditary and acquired thrombophilia in patients with upper extremity deep vein thrombosis. Results from the MAISTHRO registry. Thromb Haemost. 2008;100(3):440-446.
- Fijnheer R, Paijmans B, Verdonck LF, et al. Factor V Leiden in central venous catheter-associated thrombosis. Br J Haematol. 2002;118(1):267-270. doi:10.1046/j.1365-2141.2002.03591.x.
- Van Rooden CJ, Rosendaal FR, Meinders AE, et al. The contribution of factor V Leiden and prothrombin G20210A mutation to the risk of central venous catheterrelated thrombosis. Haematologica. 2004;89(2):201-206.
- Verlato F, Zucchetta P, Prandoni P, et al. An unexpectedly high rate of pulmonary embolism in patients with superficial thrombophlebitis of the thigh. J Vasc Surg. 1999;30(3):1113-1115. doi:10.1016/s0741-5214(99)70051-0.
- Clement DL. Superficial vein thrombosis: more dangerous than anticipated. Phlebolymphology. 2013;20(4):189-192.
- Konstantinides SV, Meyer G, Becattini C, et al. 2019 ESC Guidelines for the dignosis and management of acute pulmonary embolism development Toed in colaboration with the European Respiratory Society (ERS). Eur Heart J. 2020;41(4):543-603. doi:10.1093/eurheartj/ehz405.
Evaluation of Upper Extremity Venous Thrombosis with Doppler Ultrasonography in Peripheral Venous Line Applied Patients
Öz
Objectives: Peripherally inserted venous lines (PVL) may increase the risk of venous thrombosis due to vessel wall disarrangement. Aim of this study is to identify the cases of upper extremity venous thrombosis (UEVT) related to PVL since most of the PVLs applied to upper extremities.
Methods: Sixty-nine hospitalized patients with previous or present PVL insertions were included in this prospective study. Upper extremity Doppler compression ultrasonography (USG) examination were performed to on all patients. The cases with detected UEVTs were evaluated as group 1 and the remaining cases were evaluated as group 2. Demographic parameters, PVL applications, intravenous treatments were compared between the groups.
Results: UEVT was diagnosed by Doppler USG in 26 (37.7%) patients out of 69 patients. Lower extremity thrombosis was found in 10 (14.49%) patients. UEVT was observed in cephalic vein in 14 (53.8%) and in basilic vein in four (15.4%) out of 26 (37.7%) patients. Axillary and brachial deep UEVT was located in two (2.9%) cases. Superficial UEVT was found in 24 (34.8%) cases. Ceftriaxone, cefoperazone/sulbactam and esomeprazole were the mostly associated treatments with UEVT. UEVT was detected in five patients with PVL that were inserted only for drawing blood.
Conclusion: PVL is a risk factor for UEVT since almost 1/3 of the patients revealed UEVT. When PVL is no longer needed or the need for intravenous therapy decreases, oral therapy should be planned and PVL should be removed. Removal of PVL appears to be necessary to avoid UEVT.
Anahtar Kelimeler
Peripheral venous line upper extremity venous thrombosis Doppler ultrasonography intravenous therapy
Kaynakça
- Linnemann B, Lindhoff E. Risk factors, management and primary prevention of thrombotic complications related to the use of central venous catheters. Vasa. 2012;41(5):319-332. doi:10.1024/0301-1526/a000217.
- Blom JW, Doggen CJ, Osanto S, Rosendaal FR. Old and new risk factors for upper extremity deep venous thrombosis. J Thromb and Haemost. 2005;3(11):2471-2478. doi:10.1111/j.1538-7836.2005.01625x.
- Engelberger RP, Kucher N. Management of Deep Vein Thrombosis of the Upper Extremity. Circulation. 2012;126(6):768-773. doi:10.1161/circulationaha.111.051276.
- Grant JD, Stevens SM, Woller SC, et al. Diagnosis and management of upper extremity deep-vein thrombosis in adults. Thromb Haemost. 2012;108(6):1097-1108. doi:10.1160/th12-05-0352.
- Kalipatnapu S, Premkumar P, Selvaraj D, Agarwal S. Superficial venous thrombosis: Single-center experience and current recommendations. Indian J Vasc Endovasc Surg. 2019;6(4):235-241. doi:10.4103/ijves.ijves_25_19.
- Zingg W, Pittet D. Peripheral venous catheters: an under-evaluated problem. Int J Antimicrob Agents. 2009;34 Suppl 4:38-42. doi:10.1016/S0924-8579(09)70565-5.
- Piper R, Carr PJ, Kelsey LJ, et al. The mechanistic causes of peripheral intravenous catheter failure based on a parametric computational study. Sci Rep. 2018;8(1):3441. doi:10.1038/s41598-018-21617-1.
- Cicolini G, Manzoli L, Simonetti V, et al. Phlebitis risk varies by peripheral venous catheter site and increases after 96 hours: a large multi-center prospective study. J Adv Nurs. 2014;70(11):2539-2549. doi:10.1111/jan.12403.
- Heil J, Miesbach W, Vogl T, Bechstein WO, Reinisch A. Deep vein thrombosis of the upper extremity. Dtsch Arztebl Int. 2017;114(14):244-249. doi:10.3238/arztebl.2017.0244.
- Kilic H, Senturk A, Hasanoglu HC, et al. Incidence of upper extremity thrombosis in pulmonary thromboembolism. J Cardiovasc Surg. 2014;2(2):17-21. doi:10.5455/jcvs.2014212.
- Tesselaar ME, Ouwerkerk J, Nooy MA, Rosendaal FR, Osanto S. Risk factors for catheter-related thrombosis in cancer patients. Eur J Cancer. 2004;40(15):2253-2259. doi:10.1016/j.ejca.2004.06.023.
- Joffe HV, Kucher N, Tapson VF, Goldhaber SZ. Upper-extremity deep vein thrombosis: a prospective registry of 592 patients. Circulation. 2004;110(12):1605-1611. doi:10.1161/01.cir.0000142289.94369.d7.
- Rooden CJ, Tesselaar ME, Osanto S, Rosendaal FR, Huisman MV. Deep vein thrombosis associated with central venous catheters – a review. J Thromb Haemost. 2005;3(11):2409-2419. doi:10.1111/j.1538-7836.2005.01398.x.
- Goltz JP, Scholl A, Ritter CO, et al. Peripherally Placed Totally Implantable Venous-access Port Systems of the Forearm: Clinical Experience in 763 Consecutive Patients. Cardiovasc Intervent Radiol. 2010;33(6):1159-1167. doi:10.1007/s00270-010-9854-6.
- Kearon C, Akl EA, Comerota AJ, et al. Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl):e419S-e496S. doi:10.1378/chest.11-2301.
- Linnemann B, Meister F, Schwonberg J, et al. Hereditary and acquired thrombophilia in patients with upper extremity deep vein thrombosis. Results from the MAISTHRO registry. Thromb Haemost. 2008;100(3):440-446.
- Fijnheer R, Paijmans B, Verdonck LF, et al. Factor V Leiden in central venous catheter-associated thrombosis. Br J Haematol. 2002;118(1):267-270. doi:10.1046/j.1365-2141.2002.03591.x.
- Van Rooden CJ, Rosendaal FR, Meinders AE, et al. The contribution of factor V Leiden and prothrombin G20210A mutation to the risk of central venous catheterrelated thrombosis. Haematologica. 2004;89(2):201-206.
- Verlato F, Zucchetta P, Prandoni P, et al. An unexpectedly high rate of pulmonary embolism in patients with superficial thrombophlebitis of the thigh. J Vasc Surg. 1999;30(3):1113-1115. doi:10.1016/s0741-5214(99)70051-0.
- Clement DL. Superficial vein thrombosis: more dangerous than anticipated. Phlebolymphology. 2013;20(4):189-192.
- Konstantinides SV, Meyer G, Becattini C, et al. 2019 ESC Guidelines for the dignosis and management of acute pulmonary embolism development Toed in colaboration with the European Respiratory Society (ERS). Eur Heart J. 2020;41(4):543-603. doi:10.1093/eurheartj/ehz405.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Kalp ve Damar Cerrahisi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Haziran 2023 |
| Gönderilme Tarihi | 30 Temmuz 2022 |
| Kabul Tarihi | 9 Mayıs 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 6 Sayı: 2 |
"Acta Medica Nicomedia" Tıp dergisinde https://dergipark.org.tr/tr/pub/actamednicomedia adresinden yayımlanan makaleler açık erişime sahip olup Creative Commons Atıf-AynıLisanslaPaylaş 4.0 Uluslararası Lisansı (CC BY SA 4.0) ile lisanslanmıştır.