Dr Isabella Reid¹, Mr. Hadley Bortz¹, Ms. Samara Rosenblum¹, Dr.  Aidan Burrell¹, Miss Heather  Cleland¹

¹Alfred Hospital, ,

Abstract:

Purpose:

Hypothermia is a serious complication of severe burns that is associated with increased mortality, coagulopathy, increased transfusion requirement, surgical site infection and delayed drug metabolism (Ziegler et al. 2019; Sessler 2016). Intravascular warming catheters are an effective device to treat burns hypothermia (Prunet et al. 2012). However, the safety of intravascular warming catheters for severe burns patients has been brought into question due to their perceived added risk of clinical venous thromboembolism. The aims of this study were to identify all patients who received the intravascular warming catheter at our institution, to determine what proportion sustained a potentially catheter-related VTE and to examine the features of each case in detail.

Results:

40 patients at our institution had an intra-vascular warming catheter inserted between 2013 and 2018. 8/40 (20%) patients in the catheter group sustained a VTE of which 4/40 (10%) could have been catheter related given their anatomical location. Of the 4 potentially catheter related VTE, other preventable VTE risk factors including sub-prophylactic anticoagulation, prolonged catheter duration and prolonged hemoconcentration were identified.

Conclusions:

Our study demonstrated a potentially catheter related VTE incidence of 10%, which is not clearly higher than the VTE risk associated with standard femoral venous catheters (Joynt et al. 2000; Merrer et al. 2001). Furthermore, in the cases of VTE that were found in our study, there were other preventable VTE risk factors present such as anticoagulation under dosing, prolonged catheter use and prolonged hemoconcentration. Therefore, it is our recommendation that along with improved burns resuscitation and VTE prophylaxis, the intravascular warming catheter be reintroduced in a selected burns population and radiological guidance may be used to screen for catheter related VTE prior to the removal of catheter.

Biography:

Isabella Reid is a previous unaccredited registrar with the Alfred Plastics, Burns and Faciomaxillary Department. She is currently undertaking a PhD at the O’Brien Institute Department, St Vincents Institute for Medical Research in the field of adipose biology for tissue engineering.