Newly Published
Images in Anesthesiology  |   January 2019
Pediatric Central Line Associated Acute Deep Vein Thrombosis
Author Notes
  • From the Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
  • Correspondence: Address correspondence to Dr. Templeton: ttemplet@wakehealth.edu
Article Information
Images in Anesthesiology / Pediatric Anesthesia / Technology / Equipment / Monitoring
Images in Anesthesiology   |   January 2019
Pediatric Central Line Associated Acute Deep Vein Thrombosis
Anesthesiology Newly Published on January 31, 2019. doi:10.1097/ALN.0000000000002542
Anesthesiology Newly Published on January 31, 2019. doi:10.1097/ALN.0000000000002542
Central venous access in pediatric patients, although necessary in some critically ill patients and patients undergoing cardiac or other major surgical procedures, can be associated with acute and/or chronic deep venous thrombosis.1  While acute deep venous thromboses are rare in children, they can lead to severe complications, including postthrombotic syndrome and pulmonary embolism. Mortality rates associated with central line–related deep vein thrombosis and pulmonary embolism in children may be as high as 2.2%.2  While typically a more common perioperative complication in adults, they have become increasingly recognized in children. Even more concerning, they are frequently seen in patients with no underlying thrombophilia.2  Symptoms of acute deep venous thrombosis in a child include severe purple discoloration and attendant swelling of the involved extremity (see image). This can occur over time or, in some cases, within minutes of line placement as occurred in this patient. Prompt diagnosis is essential as the need for anticoagulation will frequently be in conflict with the need for postprocedure hemostasis.