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Venous Thromboembolism, Catheter-Related, CICU/CCU — Diagnosis of Catheter-Related VTE — Clinical Pathway: ICU and Inpatient

Venous Thromboembolism (VTE) Catheter-Related, Clinical Pathway — CICU and CCU

Cohort

This pathway guides the care of children with a catheter-related VTE, defined as a thrombus in a deep vein with a current or recently removed central venous catheter. Diagnosis is usually made using an objective radiologic test (ultrasound, MRI, CT, venogram). Children with prior catheter-related VTE are at increased risk of recurrence with subsequent catheters.

Signs of Catheter-related VTE

  • Limb pain and/or swelling
  • Catheter dysfunction
  • Recurrent bacteremia

Complications of Catheter-related VTE

  • Loss of venous access
  • Pulmonary embolization
  • Paradoxical embolism in children with R to L or mixing lesions
  • Clot extension
  • Post-thrombotic syndrome

Indications for Hypercoagulability Evaluation

  • Prior thrombosis
  • Family history of thrombosis
  • Repeat evaluations are not required
  • Use Hematology Hypercoagulability Workup order set if indicated

 

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