The Use of Thrombin Generation Assay in Detection of Central Line Related Thrombosis (CRT) in Critically Ill Patients

Inclusion Criteria:

• Age ≧ 18; AND
• Admitted to the mixed medical-surgical intensive care units of Queen Mary Hospital inHong Kong; AND
• Clinically indicated for central catheter insertion, which includes central venouscatheters and dialysis catheters; AND
• Expected to have the central catheter in place for at least 5 days in their ICU stay.

Exclusion Criteria:

• Patients known to have active venous thromboembolism including deep venous thrombosisor pulmonary embolism;
• Patients known to have hypercoagulable states, e.g., hereditary thrombophilia,antiphospholipid syndrome; OR
• Patients with active solid organ or hematological malignancies; OR
• Patients already receiving therapeutic anticoagulation prior to study recruitment; OR
• Patients with thrombosis detected in the insertion site before central catheterinsertion; OR
• Patients with a central venous catheter already in place prior to ICU admission; OR
• Patients admitted to the ICU for post-operative care; OR
• Patients admitted to the ICU for trauma care; OR
• Patients requiring extra-corporeal life support (ECLS); OR
• Patients with poor window or inaccessible for ultrasonographic examination; OR
• Pregnancy/post-partum within 6 weeks