INTRACATHETER NITROGLYCERIN INFUSION IN PREVENTION OF FEMORAL VENOUS THROMBOSIS

本研究的目的是通过超声检查探讨危重患儿股静脉置管术后静脉输注硝酸甘油对血管血栓形成的影响。我们假设，与对照导管相比，导管内注射硝酸甘油与较低的血栓发生率有关。这项研究将包括62名从出生到6岁的儿童。将对两组进行研究。第一组(硝酸甘油；n=31)将包括住进重症监护病房的危重儿童，初级保健小组已选择在其中放置双腔或三腔股静脉导管。第二组(D5W；n=31)还将包括住进重症监护病房的危重儿童，初级保健小组已选择在其体内放置双腔或三腔股静脉导管。导管插入后2天内，放射科调查员将对插管的股静脉进行超声检查和分析，并在出院前进行最终检查。主要的结果变量是超声诊断的血栓发生率在硝酸甘油组和D5W组之间的差异。次要结果变量包括两组血栓形成的临床证据的差异，两组导管相关感染发生率的差异，TPN、脂肪乳剂和肝素输注对每组血栓形成的影响，以及每组导管持续时间对血栓形成的影响。

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.