INTRACATHETER NITROGLYCERIN INFUSION IN PREVENTION OF FEMORAL VENOUS THROMBOSIS

本研究的目的是通过超声检查来研究 导管内输注硝酸甘油对血管性心绞痛发生率的影响 经皮放置股静脉导管后血栓形成 重症患儿。 我们假设导管内硝酸甘油 输注将与血栓形成的发生率较低相关， 与对照导管相比。 该研究将包括总共62个 儿童年龄从出生到6岁。 将研究两组。 组 1（硝酸甘油; n=31）将包括入院的危重儿童， 初级护理团队选择安置的重症监护病房 双腔或三腔股静脉导管。 第2组（D5 W; n=31） 还将包括进入重症监护室的危重儿童， 初级保健团队选择放置两倍或三倍的单位 腔股静脉导管。 超声波检查 将由放射科进行股静脉插管并进行分析 研究者在导管插入后2天内， 在出院前进行。 主要结局 变量是超声诊断的发病率差异 硝酸甘油组和D5 W组之间血栓形成。 次要结局 变量包括血栓形成的临床证据之间的差异 两组导管相关性感染发生率差异 两组之间，TPN、胰岛素和肝素输注的影响 以及导管持续时间对血栓形成的影响 在每一组中。

The purpose of this study is to investigate by sonography the impact of intracatheter nitroglycerin infusion upon the incidence of vascular thrombosis following percutaneous placement of femoral venous catheters in critically ill children. We hypothesize that intracatheter nitroglycerin infusion will be associated with a lower incidence of thrombosis when compared to control catheters. The study will include a total of 62 children ages birth to 6 years of age. Two groups will be studied. Group 1 (nitroglycerin; n=31) will include critically ill children admitted to the intensive care unit in whom the primary care team has elected to place a double or triple lumen femoral venous catheter. Group 2 (D5W; n=31) will also include critically ill children admitted to the intensive care unit in whom the primary care team has elected to place a double or triple lumen femoral venous catheter. Ultrasound examinations of the catheterized femoral vein will be performed and analyzed by the Radiology investigator within 2 days of catheter insertion and a final study will be performed prior to discharge from the hospital. The primary outcome variable is the difference in the incidence of ultrasound-diagnosed thrombosis between the nitroglycerin and D5W groups. Secondary outcome variables include difference in clinical evidence of thrombosis between the two groups, difference in the incidence of catheter-related infection between the two groups, impact of TPN, intralipid, and heparin infusions on thrombosis in each group, and impact of catheter duration on thrombosis in each group.