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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Howard, Scott C. Metzger, Monika L. Wilimas, Judith A. Reiss, Ulrike Baskin, Jacquelyn L. Ribeiro, Raul C. Pui, Ching-hon |
| Description | Author Affiliation: Baskin JL ( Department of Oncology and International Outreach Program, St Jude Children's Research Hospital, Memphis, TN 3105-2794, USA.) |
| Abstract | Long-term central venous catheters (CVCs) are important instruments in the care of patients with chronic illnesses, but catheter occlusions and catheter-related thromboses are common complications that can result from their use. In this Review, we summarise management of these complications. Mechanical CVC occlusions need cause-specific treatment, whereas thrombotic occlusions usually resolve with thrombolytic treatment, such as alteplase. Prophylaxis with thrombolytic flushes might prevent CVC infections and catheter-related thromboses, but confirmatory studies and cost-effectiveness analysis of this approach are needed. Risk factors for catheter-related thromboses include previous catheter infections, malposition of the catheter tip, and prothrombotic states. Catheter-related thromboses can lead to catheter infection, pulmonary embolism, and post-thrombotic syndrome. Catheter-related thromboses are usually diagnosed by Doppler ultrasonography or venography and treated with anticoagulation therapy for 6 weeks to a year, dependent on the extent of the thrombus, response to initial therapy, and whether thrombophilic factors persist. Prevention of catheter-related thromboses includes proper positioning of the CVC and prevention of infections; anticoagulation prophylaxis is not currently recommended. |
| ISSN | 01406736 |
| e-ISSN | 1474547X |
| Journal | The Lancet |
| Issue Number | 9684 |
| Volume Number | 374 |
| Language | English |
| Publisher | Elsevier |
| Publisher Date | 2009-07-11 |
| Publisher Place | Great Britain (UK) |
| Access Restriction | Open |
| Subject Keyword | Catheterization, Central Venous Adverse Effects Catheters, Indwelling Thrombosis Algorithms Anticoagulants Therapeutic Use Biomechanical Phenomena Clinical Protocols Decision Trees Equipment Failure Fibrinolytic Agents Phlebography Practice Guidelines As Topic Primary Prevention Risk Factors Therapeutic Irrigation Diagnosis Etiology Therapy Ultrasonography, Doppler Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Medicine |
| Content Type | Text |
| Resource Type | Article |
| Subject | Medicine |
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