• OnyeamaSara-Jane NSJ1Medical College of Wisconsin, Milwaukee, WI. 2Department of Pediatrics, Medical College of Wisconsin, WI. 3Critical Care Division, Children's Hospital of Wisconsin, Milwaukee, WI. 4Quantitative Health Sciences, Department of Pediatric, Sheila J Hanson, Mahua Dasgupta, Raymond G Hoffmann, Edward Vincent S Faustino, and Prophylaxis against Thrombosis Practice Study Investigators.
• 1Medical College of Wisconsin, Milwaukee, WI. 2Department of Pediatrics, Medical College of Wisconsin, WI. 3Critical Care Division, Children's Hospital of Wisconsin, Milwaukee, WI. 4Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI. 5Department of Pediatrics, Yale School of Medicine, New Haven, CT.
• Pediatr Crit Care Me. 2016 Aug 1; 17 (8): e352e361e352-61.

ObjectivesTo identify patient, hospital, and central venous catheter factors that may influence the use of low-dose heparin infusion for central venous catheter patency in critically ill children.DesignSecondary analysis of an international multicenter observational study.SettingFifty-nine PICUs over four study dates in 2012, involving seven countries.PatientsChildren less than 18 years old with a central venous catheter who were admitted to a participating unit and enrolled in the completed Prophylaxis against Thrombosis Practice study were included. All overflow patients were excluded.InterventionsNone.Measurements And Main ResultsOf the 2,484 patients in the Prophylaxis against Thrombosis Practice study, 1,312 patients had a central venous catheter. Five hundred seven of those patients used low-dose heparin infusion. The frequency of low-dose heparin infusion was compared across various patient, hospital, and central venous catheter factors using chi-square, Mann-Whitney U, and Fisher exact tests. In the multivariate analysis, age was not a significant factor for low-dose heparin infusion use. Patients with pulmonary hypertension had decreased low-dose heparin infusion use, whereas those with active surgical or trauma diagnoses had increased low-dose heparin infusion use. All centrally inserted central venous catheters were more likely to use low-dose heparin infusion when compared with peripherally inserted central venous catheters. The Asia-Pacific region showed increased low-dose heparin infusion use, along with community hospitals and smaller ICUs (< 10 beds).ConclusionsPatient, central venous catheter, and hospital factors are associated with the use of low-dose heparin infusion in critically ill children. Further study is needed to evaluate the efficacy and persistence of low-dose heparin infusion use.

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