Heparin-Bonded Central Venous Catheters Do Not Reduce Thrombosis in Infants With Congenital Heart Disease: A Blinded Randomized, Controlled Trial

Anton, Natalie; Cox, Peter N.; Massicotte, M. Patricia; Chait, Peter; Yasui, Yutaka; Dinyari, Parastoo; Marzinotto, Velma; Mitchell, Lesley

doi:10.1542/peds.2008-1508

Cited by 62 publications

(53 citation statements)

References 14 publications

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“…In a recent pediatric randomized, controlled, blinded, single-center trial, infants younger than 1 year old with congenital heart disease requiring a central venous line for clinical care were randomly assigned to receive either a heparin-bonded catheter or a standard non-heparin-bonded catheter. No advantage in using heparin-bonded catheters was identified [82]. All things considered, the data remain insufficient to recommend the systematic use of either of these catheters.…”

Section: Prevention Of Bsismentioning

confidence: 99%

Healthcare-associated infection prevention in pediatric intensive care units: a review

Joram

Blanquat

Stamm

et al. 2012

Eur J Clin Microbiol Infect Dis

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The objective of this review was to summarize the current knowledge base on the prevention of nosocomial infections in pediatric intensive care units (PICUs). Healthcare-associated infections (HAIs) are a crucial problem in PICUs because of their impact on patient outcome, length of hospital stay, and costs. Studies published between 1998 and 2011 were identified using the MEDLINE and Cochrane databases. Randomized, cohort, case-control studies, and meta-analyses concerning global strategies of prevention, general organization of the wards, general recommendations on antibiotic management, and measures for the prevention of ventilator-associated pneumonia (VAP), bloodstream infections (BSIs), urinary tract infections (UTIs), and surgical site infections (SSIs) were incorporated. Limits of age from 1 month to 18 years were used. When recommendations could not be supported by the pediatric literature, adult studies were also reviewed. This review excludes the neonate population. Specific pediatric data are often lacking so as to establish specific evidence-based pediatric recommendations. This review underlines the absolute necessity of pediatric studies and to harmonize the definitions of HAIs.

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Section: Prevention Of Bsismentioning

confidence: 99%

Healthcare-associated infection prevention in pediatric intensive care units: a review

Joram

Blanquat

Stamm

et al. 2012

Eur J Clin Microbiol Infect Dis

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“…Systemic anticoagulation, however, places patients at high risk for bleeding, which often can be life-threatening. Although extensive work has been done to develop extracorporeal circuits with nonthrombogenic surface properties, clinical success has been equivocal and the use of such devices has been limited to specific clinical scenarios 1–8 . The ideal biomaterial for extracorporeal circulatory devices is one that is similar to vascular endothelium.…”

Section: Introductionmentioning

confidence: 99%

The immobilization of a direct thrombin inhibitor to a polyurethane as a nonthrombogenic surface coating for extracorporeal circulation

Brisbois

Handa

et al. 2016

J. Mater. Chem. B

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A biomaterial with both antithrombin and antiplatelet properties is the ideal surface for use in extracorporeal circulation (ECC) as it targets both fibrin generation and platelet adhesion. A hemocompatible surface coating avoids the need for systemic anticoagulation by providing a local anticoagulant effect at the polymer-blood interface. Previous work has demonstrated the potential use of argatroban, a direct thrombin inhibitor, as a nonthrombogenic material for extracorporeal devices. The work reported here focuses on the characterization of argatroban linked to a polyurethane-silicone polymer, CarboSil®. Chemical immobilization, the amount of argatroban, incubation times, and saturation point were evaluated to achieve maximal antithrombin activity at the polymer surface. Cross-linked polymer coatings reacted with 10 and 30 µmole of argatroban were prepared and tested. These coatings resulted in argatroban activity levels of 0.131 µM and 0.446 µM, respectively. After refining the cross-linking process, argatroban activity increased by approximately 3.6 fold. Maintenance of activity and leaching from the polymer surface were also evaluated. Using the refined process for linking argatroban to polymer, the resulting polymer was applied as a surface coating to the inner lumen of poly(vinyl chloride) ECC circuit tubing and its antithrombin effect evaluated using a 4 h rabbit ECC model. Following 4 h of blood exposure, the argatroban circuit demonstrated significantly less thrombus formation compared to the control CarboSil® coating with a 4.1 cm2 thrombus average area for the control coating compared to 1.2 cm2 for the argatroban coating (n=4). There was no significant change in thrombin time from baseline in plasma from animals in which the argatroban coated circuit was used, with a thrombin time of 16.2 s at t=0 and 14.5 s after 4 h. These results demonstrate the potential efficacy of immobilized argatroban as a hemocompatible biomaterial for extracorporeal life support devices.

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“…Thrombi usually develop within several days after the catheter has been inserted. Prospective studies have revealed that deep vein thrombosis develops in 12−28% of the children [35,36]; in infants, this risk is higher, i.e., 44% [37]. Therefore, thrombosis in children with central venous catheters has been increasingly considered to be a significant problem, especially because none of the methods used has been demonstrated to provide full protection, except for the removal of cannulas as soon as possible.…”

Section: Intravenous Accessesmentioning

confidence: 99%

Zasady leczenia żywieniowego na oddziałach intensywnej terapii dziecięcej. Wspólne stanowisko towarzystw naukowych: Sekcji Anestezji i Intensywnej Terapii Dziecięcej PTAiIT, PTN, PTŻKD

Bartkowska-Śniatkowska¹,

Zielińska²,

Świder³

et al. 2015

Anaesthesiol Intensive Ther

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Providing nutritional therapy via the gastrointestinal tract in patients in paediatric intensive care units (PICUs) is an effective method for delivering energy and other nutrients. In the event of contraindications to using this method, it is necessary to commence parenteral nutrition. In the present study, methods for nutritional treatments in critically ill children are presented, depending on the clinical situation.

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Heparin-Bonded Central Venous Catheters Do Not Reduce Thrombosis in Infants With Congenital Heart Disease: A Blinded Randomized, Controlled Trial

Abstract: Infants with congenital heart disease are at significant risk of both silent and clinically identified thrombosis. There seems to be no advantage in using heparin-bonded catheters in infants

Cited by 62 publications

References 14 publications

Healthcare-associated infection prevention in pediatric intensive care units: a review

Healthcare-associated infection prevention in pediatric intensive care units: a review

The immobilization of a direct thrombin inhibitor to a polyurethane as a nonthrombogenic surface coating for extracorporeal circulation

Zasady leczenia żywieniowego na oddziałach intensywnej terapii dziecięcej. Wspólne stanowisko towarzystw naukowych: Sekcji Anestezji i Intensywnej Terapii Dziecięcej PTAiIT, PTN, PTŻKD

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