Incidence of Catheter Related Thrombosis in Chronic Kidney Disease Patients Admitted in Intensive Care Unit and their Outcome: An Observational Study

Central Venous Catheter (CVC) insertion is a commonly performed procedure in the Intensive Care Unit (ICU) to facilitate administration of intravenous fluids and drugs, Central Venous Pressure (CVP) measurement, and Haemodialysis (HD). It is associated with various complications including thrombus formation. Aim:To determine the incidence of thrombus, its extent, associated risk factors and outcomes, in the triple lumen HD catheter inserted in Internal Jugular Vein (IJV) in Chronic Kidney Disease (CKD) patients admitted in the ICU. Materials and Methods: This was a prospective observational study including a total of 100 patients (63 males and 37 females) of CKD, who required HD in the ICU at Pacific Institute of Medical Sciences (PIMS), Girwa, Udaipur, Rajasthan, India. The study was done from March 2017 to Mrach 2018. After admission in ICU, Arterial Blood Gas (ABG) was performed and Electrocardiography (ECG), Noninvasive Blood Pressure (NIBP), Oxygen Saturation (SpO2) monitoring was done. A triple lumen HD catheter was inserted in the IJV under all aseptic precautions. After two weeks of insertion, a colour doppler Ultrasonography (USG) neck was performed to see the presence, size and extent of thrombus in the CVC. All the pre and postprocedural demographic and clinical data of relevant investigations, past history, risk factors and complications were compiled together and compared in Microsoft excel sheet and Statistical Package for the Social Sciences (SPSS)softwares for relevant results. Results: The study found that 30% were having thrombus after two weeks of HD catheter in the IJV and most commonly detected in the diabetic patients with CKD 10 (33.33%), followed by hypertension two (6.66%), cerebro-vascular accidents one(3.33%), chronic liver diseases one (3.33%) and no thrombus was detected in patients suffering from ischemic heart diseases. The most common risk factor for thrombus formation was chronic smoking 12(40%), followed by bedridden patients two(6.66%), and chronic alcoholic patients 2(6.66%). Conclusion: This study found that early catheter-related thrombus was common in male patients with diagnosed diabetes mellitus and chronic smoking is the most common associated risk factor.