%0 Journal Article %T Subclavian central venous catheter-related thrombosis in trauma patients: incidence, risk factors and influence of polyurethane type. %+ Service d'Anesthésie et de Réanimation 1 %+ Fédération d'anesthésie-réanimation, urgences, chirurgie ambulatoire %+ Département de Matériovigilance %+ Laboratoire d'Hématologie %+ Adaptation cardiovasculaire à l'ischémie %A Gentile, Ariane %A Petit, Laurent %A Masson, Françoise %A Cottenceau, Vincent %A Bertrand-Barat, Josseline %A Freyburger, Geneviève %A Pinaquy, Catherine %A Léger, Alain %A Cochard, Jean-François %A Sztark, François %< avec comité de lecture %@ 1364-8535 %J Critical Care %I BioMed Central %V 17 %N 3 %P R103 %8 2013-05-29 %D 2013 %R 10.1186/cc12748 %M 23718723 %K central venous catheter %K upper extremity deep vein thrombosis %K risk factors %K multiple trauma %K intracranial hypertension %Z Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO]Journal articles %X INTRODUCTION: The incidence of deep venous thrombosis (DVT) related to a central venous catheter varies considerably in ICUs depending on the population included. The aim of this study was to determine subclavian central venous catheter (SCVC)-related DVT risk factors in severely traumatized patients with regard to two kinds of polyurethane catheters. METHODS: Critically ill trauma patients needing a SCVC for their usual care were prospectively included in an observational study. Depending on the month of inclusion, patients received one of the two available products in the emergency unit: either an aromatic polyurethane SCVC or an aliphatic polyurethane SCVC. Patients were screened weekly by ultrasound for SCVC-related DVT. Potential risk factors were collected, including history-related, trauma-related and SCVC-related characteristics. RESULTS: A total of 186 patients were included with a median Injury Severity Sore of 30 and a high rate of severe brain injuries (21% of high intracranial pressure). Incidence of SCVC-related DVT was 37% (95% confidence interval: 26 to 40) in patients or 20/1,000 catheter-days. SCVC-related DVT occurred within 8 days in 65% of cases. There was no significant difference in DVT rates between the aromatic polyurethane and aliphatic polyurethane SCVC groups (38% vs. 36%). SCVC-related DVT independent risk factors were age >30 years, intracranial hypertension, massive transfusion (>10 packed red blood cell units), SCVC tip position in the internal jugular or in the innominate vein, and ipsilateral jugular catheter. CONCLUSION: SCVC-related DVT concerned one-third of these severely traumatized patients and was mostly clinically silent. Incidence did not depend on the type of polyurethane but was related to age >30 years, intracranial hypertension or misplacement of the SCVC. Further studies are needed to assess the cost-effectiveness of routine screening in these patients in whom thromboprophylaxis may be hazardous. %G English %2 https://inserm.hal.science/inserm-00850692/document %2 https://inserm.hal.science/inserm-00850692/file/cc12748.pdf %L inserm-00850692 %U https://inserm.hal.science/inserm-00850692 %~ INSERM