Catheter-related thrombosis in critically ill children: Comparison of catheters with and without heparin bonding☆,☆☆,★
Section snippets
Patients
The study took place prospectively between March and December 1993 in our 16-bed, multidisciplinary unit with more than 1000 admissions each year. Deep venous catheters are used in approximately 20% of the patients admitted to this unit. All patients between birth and the age of 8 years who had 8 to 15 cm femoral venous catheters placed were eligible for entry into the study. Patients were excluded from the study if there was a history of vascular thrombosis, previous femoral venous
RESULTS
Fifty patients were enrolled at a median age of 6.5 months (range, 0.5 to 88 months); 25 were enrolled in the heparin-bonded and 25 in the standard-catheter groups (Table). Patient, infusate, and catheter data did not differ with the exception that one group had heparin-bonded catheters placed and the other group had standard catheters placed. Vascular thrombosis developed in 13 (26%) of 50 patients overall, 11 (44%) of 25 patients in the standard-catheter group and 2 (8%) of 25 patients in the
DISCUSSION
Heparin prevents thrombosis and thrombus extension8, 9, 10 and is therefore a logical coating in attempts to decrease catheter-related thrombosis. Heparin-bonded catheters have been associated with diminished adherent thrombi and fibrin sheath formation around the catheter in adults5, 11 and with decreased vascular thrombosis in an animal model. 12 The effect of heparin-bonded catheters on the formation of mural thrombosis has not been studied in human subjects.
Our patients with heparin-bonded
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Central Venous Catheters for Hemodialysis—the Myth and the Evidence
2021, Kidney International ReportsCitation Excerpt :Two meta-analyses of chlorhexidine-silver sulfadiazine–coated catheters revealed significant reductions in CR-BSI (odds ratio 0.56; 95% CI 0.37–0.84; P = 0.005 and odds ratio 0.68; 95% CI 0.47–0.98, respectively) and significantly lower rates of catheter colonization (odds ratio 0.44; 95% CI 0.36–0.54; P < 0.001 and odds ratio 0.51; 95% CI 0.42–0.61, respectively).18,19 Similarly, heparin-bonded CVCs for infusion are associated with a significantly lower rate of catheter thrombosis (8% vs. 44%; P = 0.004).20 Consequently, antimicrobial-coated catheters are preferred in situations where adherence to maximal antisepsis measures have not adequately reduced rates of CR-BSI.21,22
Epidemiology and outcomes of clinically unsuspected venous thromboembolism in children: A systematic review
2020, Journal of Thrombosis and HaemostasisDo asymptomatic clots in children matter?
2020, Thrombosis ResearchEtiology, presenting features and outcome of children with non-cirrhotic portal vein thrombosis: A multicentre national study
2019, Digestive and Liver DiseaseCitation Excerpt :The most common neonatal illness were the respiratory complications of prematurity (53%) and congenital malformations (20%), while sepsis was documented in only 9% of cases. In the literature the prevalence of sepsis is quite variable [18–23]; in Shakka’s study, among 17 neonates with PVT, the percentage of patients who experienced sepsis was 65% of cases [24]. The most common type of presentation included the detection of splenomegaly and hypersplenism and an episode of GI bleeding.
ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Venous access
2018, Clinical NutritionCitation Excerpt :Prevention of infection – a thrombus or the biofilm in the internal lumen of the catheter may serve as a nidus for microbial colonization [119,120]. Heparin bonded catheters are reported to decrease bacterial adherence [121] as well as lowering the incidence of positive blood cultures, possibly by lowering the incidence of thrombus [109], or reducing the number of organisms attached to the surface of the catheter [117]. Activation of lipoprotein lipase – given in infusion, heparin also activates lipoprotein lipase and increases lipolysis and re-esterification of infused triglycerides, but has no effect on lipid oxidation and net energy gain [122–125].
Clinical Syndromes of Device-Associated Infections
2018, Principles and Practice of Pediatric Infectious Diseases
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From the Departments of Critical Care and Diagnostic Imaging, Children's National Medical Center, Washington, D.C., and the Departments of Anesthesiology and Pediatrics, George Washington University School of Medicine, Washington, D.C. Submitted in part by a research grant from Cook Incorporated. Presented at the Society of Critical Care Medicine 1994 Educational & Scientific Symposium.
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Reprint requests: Brian Krafte-Jacobs, MD, Division of Critical Care Medicine, Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH 45229.
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