Summary

Venous thromboembolic events (VTE) in children are frequentlyassociated with central venous lines (CVL). Identifying risk factorsrelated to CVL management could potentially minimizeCVL-related thrombotic complications. The objectives of thestudy were to assess whether CVL location, type, size, and durationof placement are associated with the incidence of VTE inchildren.The study was a prospective, multicentre cohort studyin a general pediatric population requiring CVL. Data on CVLcharacteristics were documented prospectively using standardizedcase report forms. Outcome assessments were by i) clinicalmonitoring for symptomatic VTE which were confirmed byappropriate objective test, or ii) screening by venography atstudy exit.Among 158 children, 21 (13%) hadVTE.The incidence of VTE was increased with femoral CVL (32%) and subclavianCVL (27%) compared to brachial CVL (12%) and jugular CVL(8%;p=0.01).The incidence ofVTE was independent of CVL type(peripherally inserted central catheters, untunneled CVL, tunneledexteriorized CVL, subcutaneous ports; p=0.90), and CVLsize (CVL diameter, p=0.42; number of CVL lumen, p=0.58).Theincidence of VTE did not increase with duration of CVL placement:0–5 days (17% VTE), 6–20 days (19%), 21–35 days (10%),and 36–50 days (11%,p=0.68).The incidence of CVL-relatedVTEmay be reduced by preferred placement of CVL in brachial orjugular veins.The choice of CVL type and size does not significantlyinfluence the risk of VTE. Short-term CVL are associatedwith a similar risk of VTE as longer-term CVL.