M. Mompontet, S. Breinig and C. Morin (2025). Central venous catheter-related deep vein thrombosis in severe inaugural diabetic ketoacidosis: A four case-report and literature review. Archives de pediatrie : organe officiel de la Societe francaise de pediatrie, 32(3), 213-215. https://doi.org/10.1016/j.arcped.2025.01.003

PubMed 40107906

[Abstract]
INTRODUCTION: Type 1 diabetes (T1D), particularly diabetic ketoacidosis (DKA), is believed to induce a prothrombotic state, mainly due to activation of the coagulation system, platelets, and relative hypofibrinolysis.

OBSERVATIONS AND DISCUSSION: A central venous catheter (CVC) can be necessary in cases of severe inaugural DKA in the pediatric intensive care unit (PICU). Children with a CVC are at increased risk of thrombosis, particularly before the age of three. Following a literature review and our experience in Toulouse (4 cases) of CVC-related thrombosis, we propose that CVC placement should be avoided as much as possible and alternative venous access should be preferred to minimize the risk of thrombosis.

CONCLUSION: If CVC placement cannot be avoided, preventive anticoagulation should be considered, but further studies are needed to establish a proper protocol.