Abstract：
Central venous catheter (CVC)-related thrombosis (CRT) is a known complication in critically ill patients. However, its clinical significance remains unclear. The objective of the study was to evaluate the occurrence and evolution of CRT from CVC insertion to removal.
A prospective multicenter study was conducted in 28 intensive care units (ICUs). Duplex ultrasound was performed daily from CVC insertion until at least 3 days after CVC removal or before patient discharge from the ICU to detect CRT and to follow its progression. CRT diameter and length were measured and diameter > 7 mm was considered extensive.
The study included 1262 patients. The incidence of CRT was 16.9% (95% confidence interval 14.8-18.9%). CRT was most commonly found in the internal jugular vein. The median time from CVC insertion to CRT onset was 4 (2-7) days, and 12% of CRTs occurred on the first day and 82% within 7 days of CVC insertion. CRT diameters > 5 mm and > 7 mm were found in 48% and 30% of thromboses. Over a 7-day follow-up, CRT diameter remained stable when the CVC was in place, whereas it gradually decreased after CVC removal. The ICU length of stay was longer in patients with CRT than in those without CRT, and the mortality was not different.
CRT is a frequent complication. It can occur as soon as the CVC is placed and mostly during the first week following catheterization. Half of the thromboses are small but one-third are extensive. They are often non-progressive and may be resolved after CVC removal.
A prospective multicenter study was conducted in 28 intensive care units (ICUs). Duplex ultrasound was performed daily from CVC insertion until at least 3 days after CVC removal or before patient discharge from the ICU to detect CRT and to follow its progression. CRT diameter and length were measured and diameter > 7 mm was considered extensive.
The study included 1262 patients. The incidence of CRT was 16.9% (95% confidence interval 14.8-18.9%). CRT was most commonly found in the internal jugular vein. The median time from CVC insertion to CRT onset was 4 (2-7) days, and 12% of CRTs occurred on the first day and 82% within 7 days of CVC insertion. CRT diameters > 5 mm and > 7 mm were found in 48% and 30% of thromboses. Over a 7-day follow-up, CRT diameter remained stable when the CVC was in place, whereas it gradually decreased after CVC removal. The ICU length of stay was longer in patients with CRT than in those without CRT, and the mortality was not different.
CRT is a frequent complication. It can occur as soon as the CVC is placed and mostly during the first week following catheterization. Half of the thromboses are small but one-third are extensive. They are often non-progressive and may be resolved after CVC removal.
摘要：
目的：中心静脉导管（CVC）相关性血栓形成（CRT）是危重患者的已知并发症。然而,其临床意义尚不清楚.该研究的目的是评估CRT从CVC插入到移除的发生和演变。
方法：在28个重症监护病房（ICU）进行了一项前瞻性多中心研究。从CVC插入开始每天进行双重超声检查，直到CVC移除后或患者从ICU出院前至少3天，以检测CRT并跟踪其进展。测量CRT直径和长度,认为直径>7mm是大范围的。
结果：该研究包括1262名患者。CRT发生率为16.9%(95%置信区间14.8-18.9%)。CRT最常见于颈内静脉。从CVC插入到CRT发作的中位时间为4（2-7）天，12%的CRT发生在CVC插入后的第一天，82%发生在CVC插入后的7天内。在48%和30%的血栓形成中发现CRT直径>5mm和>7mm。经过7天的随访，当CVC就位时，CRT直径保持稳定，而CVC去除后逐渐下降。接受CRT的患者的ICU住院时间长于没有接受CRT的患者，死亡率也没有什么不同。
结论：CRT是一种常见的并发症。它可以在CVC放置后立即发生，并且主要在导管插入后的第一周内发生。一半的血栓很小，但三分之一是广泛的。它们通常是非进行性的，可以在CVC去除后解决。
方法：在28个重症监护病房（ICU）进行了一项前瞻性多中心研究。从CVC插入开始每天进行双重超声检查，直到CVC移除后或患者从ICU出院前至少3天，以检测CRT并跟踪其进展。测量CRT直径和长度,认为直径>7mm是大范围的。
结果：该研究包括1262名患者。CRT发生率为16.9%(95%置信区间14.8-18.9%)。CRT最常见于颈内静脉。从CVC插入到CRT发作的中位时间为4（2-7）天，12%的CRT发生在CVC插入后的第一天，82%发生在CVC插入后的7天内。在48%和30%的血栓形成中发现CRT直径>5mm和>7mm。经过7天的随访，当CVC就位时，CRT直径保持稳定，而CVC去除后逐渐下降。接受CRT的患者的ICU住院时间长于没有接受CRT的患者，死亡率也没有什么不同。
结论：CRT是一种常见的并发症。它可以在CVC放置后立即发生，并且主要在导管插入后的第一周内发生。一半的血栓很小，但三分之一是广泛的。它们通常是非进行性的，可以在CVC去除后解决。
