Thrombus prevalence and risk factors in critically ill pediatric patients

We aimed to ascertain the prevalence of venous and arterial thrombus, potential thrombosis-inducing factors, and underlying medical conditions in critically ill pediatric patients admitted to our pediatric intensive care unit. We included patients who were admitted to our tertiary pediatric intensive care unit for 24 hours between June 2016 and June 2021 and had venous or arterial thrombosis confirmed by Doppler ultrasonography. Thirty patients with confirmed thrombosis who underwent Doppler ultrasonography and thirty patients without thrombosis, matched based on age and gender, were included in the control group. The female gender accounted for 63.3% of the patients in the thrombosis group. There was no significant gender difference between the thrombosis group and the control group. Age (in months), height, weight, and body mass index measurements were similar in both groups. The most common reason for hospitalization in the thrombosis group was post-operative care (n = 7; 23.3%). Thrombosis typically occurred after a mean of 6.9 ± 4.9 days of hospitalization. Coagulation parameters, Protein C, Protein S, homocysteine levels, pediatric mortality index (PIM), pediatric risk of mortality (PRISM-2), and Braden Q scores evaluating pressure ulcersdid not differ significantly between the two groups. Eleven patients in the thrombosis group were screened for the prothrombin 20210A mutation, with all results being normal; eleven patients in the patient group were tested for Factor V Leiden mutation, and nine patients in the control group had no mutation. The thrombosis group had a significantly lower rate of mechanical ventilation and hemodialysis. Factors such as trauma, infection, heart failure, malignancy, history of chemotherapy, immobilization, presence of central catheter, history of surgical intervention, family history, and nephrotic syndrome were not significantly associated with thrombosis development. Central venous and arterial catheterization was identified as the most crucial acquired risk factor for thrombosis.

Arterial; Pediatric intensive care; Thrombosis; Venous

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