Ultrasound for Diagnosis of Central Venous Catheterization-related Thrombosis in Intensive Care Unit: A Prospective Observational Study

Background: Central venous catheterization (CVC) is frequently performed in the intensive care unit (ICU) for multiple reasons.Although thrombosis is a recognized complication of CVC insertion, data regarding its impact remain limited.Thrombosis associated with CVC can increase morbidity and mortality among ICU patients.This study aimed to identify the prevalence of thrombosis with a CVC line, the risk factors for thrombosis, and its associated morbidity.Methods: A prospective observational study of 39 patients admitted to a tertiary care ICU over 3 months (July-September 2022) examined the prevalence of thrombosis with CVC placement as the primary outcome.Ultrasonograms (USGs) were performed on days 0 and 3 and the day of removal to evaluate the incidence, size, and clinical significance of the thrombus. Results:The study revealed an unexpectedly high thrombosis rate (53%) among CVC patients, with a greater incidence in men (60%) compared to women (38%).Thrombosis occurred more frequently in the internal jugular vein (IJV) than in the subclavian vein (SCV), and in the IJV, thrombosis was significantly more common on the left side (68%) versus the right (35%) (p = 0.042).Sepsis (80%) and the administration of intravenous immunoglobulin (IVIG) (100%) were associated with increased thrombosis risk.Thrombosis was detected as early as the 3rd day postinsertion (mean duration of 4.52 1.81 days).The study also found that deep vein thrombosis (DVT) prophylaxis did not affect thrombosis occurrence.Conclusion: Central venous catheters (CVC) are linked to a considerable occurrence of blood clots, with septic patients and those receiving IVIG facing an elevated risk of clot formation.Our observations did not indicate any substantial rise in death rates associated with thrombosis.