Thromboembolic events in PICU: A descriptive study

In response to an increased incidence of deep vein thrombosis (DVT) in a pediatric intensive care unit (PICU), nurses and physicians convened at an interprofessional meeting to discuss the problem and planned this descriptive study. The purpose of the study was to describe the characteristics of children who are in the PICU with a central venous access device (CVAD) and develop a DVT. Because prevention and early recognition of DVT decreases morbidity and mortality, identifying at-risk children is important. The study used a descriptive design with a chart review that included 42 charts from 2007-2012 and 34 charts during the 12-month prospective arm (N = 76). Although correlations did not reach statistical significance, the results may have clinical importance. Overall, the age and weight of children with DVT were less than children without DVT. There were six children with DVTs in the sample; the most common admitting diagnosis for children with DVT was respiratory condition/infection, which is consistent with infections as an established risk factor for DVT. Laboratory values were evaluated; children with DVT had lower white blood cell counts, lower hemoglobin levels, and higher hematocrits. Use of a standardized reliable screening tool, promoting adequate hydration status, and interprofessional electronic documentation are clinical recommendations.