Open Access

ARTICLE

Chinese Expert Consensus on the Prevention and Management of Thrombosis Associated with Central Venous Catheters in Children with Congenital Heart Disease

Wenyi Luo^1,#, Li Yuan^1,#, Ruiling Feng², Kai Pu³, Yali Huang⁴, Mingxiong Li³, Xiaomin Tang⁵, Huimei Wang⁶, Xuejing Wang⁷, Wentin Zhang⁸, Hong Zheng⁹, Xiuhong Li¹⁰, Dandong Luo¹¹, Shanshan Shi⁵, Yaqin Shu³, Xu Wang¹², Na Du¹³, Yujie Shen¹⁴, Yamin Song¹⁵, Huihua Wang¹⁶, Xia Xie¹⁷, Qian Zhang¹², Qianqian Zhang¹⁸, Yuanyuan Zhang¹⁹, Yueyue Zhang¹, Xiaojie Hu²⁰, Zhimin Li²¹, Xiaolan Pan¹⁰, Youdong Pan²², Wenyuan Shang²³, Hairui Sun²⁴, Beini Wang²⁵, Yanhua Wang²⁶, Yanyan Wang²⁷, Yongting Wang²⁸, Guihong Yang²⁹, Yan Zhou³⁰, Zhimin Yang¹, Xuanxuan Li¹, Huiwen Chen^1,§,*, Zhuoming Xu^1,§,*

1 Department of Cardiothoracic Surgery, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
2 Department of Cardiothoracic Surgery, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital, Zhengzhou, China
3 Department of Cardiothoracic Surgery, Children’s Hospital of Nanjing Medical University, Nanjing, China
4 Department of Cardiothoracic Surgery, Fujian Children’s Hospital (Fujian Branch of Shanghai Children’s Medical Center), College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
5 Department of Cardiothoracic Surgery, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents’ Health and Disease, Hangzhou, China
6 Department of Cardiothoracic Surgery, Children’s Hospital of Fudan University, Shanghai, China
7 Department of Cardiothoracic Surgery, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
8 Department of Cardiothoracic Surgery, Children’s Hospital of Soochow University, Suzhou, China
9 Department of Pediatric Cardiovascular Nursing West China Second University Hospital, Sichuan University/West China School of Nursing Sichuan University, Chengdu, China
10 Department of Cardiothoracic Surgery, Shenzhen Children’s Hospital, Shenzhen, China
11 Department of Cardiothoracic Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
12 Department of Pediatric Intensive Care Unit, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
13 Department of Cardiothoracic Surgery, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
14 Department of Cardiothoracic Surgery, Children’s Hospital of Chongqing Medical University, Chongqing, China
15 Department of Cardiothoracic Surgery, Guangdong Cardiovascular Institute, Guangzhou, China
16 Department of Cardiothoracic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
17 Department of Cardiac Intensive Care Unit, Xiangya Hospital of Central South University, Changsha, China
18 Department of Cardiothoracic Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
19 Department of Cardiac Intensive Care Unit, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, China
20 Department of Cardiac Intensive Care Unit, Xiamen Children’s Hospital (Children’s Hospital of Fudan University at Xiamen), Xiamen, China
21 Department of Emergency and Critical Care Medicine, Anhui Children’s Hospital, Hefei, China
22 Department of Cardiac Intensive Care Unit, Dalian Municipal Women and Children’s Medical Center (Group), Dalian, China
23 Department of Pediatric Cardiac Intensive Care Unit, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
24 Department of Pediatric Intensive Care Unit, First Hospital of Jilin University, Changchun, China
25 Department of Cardiothoracic Surgery, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
26 Department of Cardiothoracic Surgery, Hebei Children′s Hospital, Shijiazhuang, China
27 Department of Cardiothoracic Surgery, Qingdao Women and Children’s Hospital, Qingdao, China
28 Department of Cardiothoracic Surgery, Henan Provincial Chest Hospital, Zhengzhou, China
29 Department of Cardiothoracic Surgery, Hunan Children’s Hospital, Changsha, China
30 Department of Nursing, The 2nd Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China

* Corresponding Authors: Huiwen Chen. Email: ; Zhuoming Xu. Email:
# These authors contributed equally to this work and should be considered first authors
§ These authors contributed equally to this work and should be considered co-corresponding authors

Structural and Congenital Heart Disease 2026, 21(2), 1 https://doi.org/10.32604/schd.2026.082239

Received 12 March 2026; Accepted 27 May 2026; Issue published 11 June 2026

Abstract

Objective: To develop the Chinese expert consensus on the prevention and management of central venous catheter (CVC)-related thrombosis in children with congenital heart disease (CHD) (hereafter referred to as the Consensus), with the aim of standardizing and improving preventive and therapeutic strategies for CVC-related thrombosis in pediatric patients with CHD. Methods: The consensus was formulated in strict accordance with the principles of evidence-based medicine by a multidisciplinary panel of experts. Evidence was appraised and synthesized using the JBI Evidence Grading System. The initial draft was refined through two rounds of Delphi consultations involving 16 experts and one expert panel meeting with 15 participants. Statistical analyses demonstrated a high level of agreement among experts, leading to the establishment of a strong consensus. Subsequently, between September and November 2025, the document underwent further revision through an additional two rounds of Delphi surveys (n = 16) and one expert deliberation meeting (n = 15). Quantitative methods were employed to assess expert participation, authority, and the degree of consensus. Results: A two-round Delphi consultation was conducted with 16 experts per round, achieving a 100% effective response rate in both rounds. Fourteen experts provided constructive suggestions in the first round, and two in the second round. The expert authority coefficient (Cr) was 0.93 (familiarity coefficient 0.91, judgment basis coefficient 0.94). In the first round, item-level coefficients of variation (CVs) ranged from 0.05 to 0.21, and Kendall’s coefficient of concordance (W) was 0.158 (χ² = 68.342, p < 0.001). In the second round, CVs narrowed to 0–0.15 and Kendall’s W increased to 0.191 (χ² = 72.565, p < 0.001), indicating improved consensus. Subsequently, a panel review meeting with 15 experts (100% participation, Cr = 0.91) yielded CVs of 0–0.12 and Kendall’s W of 0.224 (χ² = 59.118, p < 0.001), demonstrating good consistency. Through this iterative process, the final consensus was established. Conclusions: The development of this consensus was methodologically rigorous, characterized by a highly representative expert panel and a strong level of agreement. It provides clinical nursing professionals with a structured and standardized framework for the prevention and management of CVC-related thrombosis in children with CHD. The consensus holds substantial clinical value in guiding standardized practice, reducing the incidence of thrombosis, and improving patient outcomes.

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