Placing Central Lines and DVTs?

Does the simple act of inserting a central venous catheter induce a hypercoagulable state in patients?

Courtesy Wikimedia Commons/Jsonp/Public domain

Research presented at the Eastern Association for the Surgery of Trauma shows that central venous line insertion significantly decreases clotting time and initial clot formation time and accelerates fibrin cross-linking in both healthy swine and critically ill patients.

The findings indicate that CV catheters induce a systemic hypercoagulable state, probably because of the endothelial injury, which may explain the increased risk for venous thromboembolism associated with central venous lines, said lead author Dr. Mark Ryan, with the University of Miami School of Medicine.

The prospective, observational trial involved eight patients whose blood was drawn from an indwelling peripheral arterial catheter before and 60 minutes after central venous line catheterization and analyzed with thromboelastography (TEG). Ten swine consented to having their blood drawn as well.

The group previously reported that placing a pulmonary artery catheter in critically ill patients and healthy swine significantly decreases the time to initial fibrin formation, thereby inducing a hypercoagulable state.

WENDLING/Elsevier Global Medical News

As in the current study, however, no changes were observed in conventional coagulation parameters, raising questions as to why standard coagulation tests fail to correlate with TEG and whether the prothrombotic state identified by TEG truly indicates an increased risk for deep vein thrombosis, Dr. Ryan said.

Finally, as has been suggested by other investigators, pigs may simply have a very different hypercoagulable state than humans do. I selfishly hope so.

–Patrice Wendling

1 Comment

Filed under IMNG, Thoracic Surgery, Uncategorized

One response to “Placing Central Lines and DVTs?

  1. マークバイマークジェイコブスバッグ 激安
    You’ve made some really good points there. I looked on the internet for more information about the issue and found most people will go along with your views on this website.

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