Ultrasound screening for internal jugular vein thrombosis aids the detection of central venous catheter‐related infections in patients with haemato‐oncological diseases: a prospective observational study

Abstract

Summary. To prove the hypothesis that central venous catheter‐related thrombosis and infection are associated, 43 haemato‐oncological patients with an internal jugular vein catheter underwent ultrasound screening for thrombosis every 4 d. Catheter‐related thrombosis was detected in 13/43 patients (30%). Catheter‐related infection, as defined by the U.S. Hospital Infection Control Practices Advisory Committee, was found in 14/43 patients (33%) with colonization of the catheter in two patients, exit site infection in eight patients and catheter‐related bloodstream infection in four patients. Catheter‐related thrombosis and catheter‐related infection coincided in 12 patients and were significantly correlated (Fisher's exact test, P < 0·0001). Detection of thrombosis indicated a catheter‐related infection with a superior sensitivity (86%vs 57%) and an equivalent specificity (97%) compared with the presence of clinical signs (erythema, tenderness, warmth or swelling). Neutropenia, which occurred in 32 patients, was found in 13/14 patients (93%) with a catheter‐related infection and, therefore, seemed to be an important covariate for the development of a catheter‐related infection. This study showed a close correlation between catheter‐related thrombosis and infection. Ultrasound screening for thrombosis was helpful for detecting catheter‐related infection. These findings could be clinically useful for the handling of central venous catheters in patients with an elevated risk of infectious complications.