Heparin Bonding Reduces Thrombogenicity of Pulmonary-Artery Catheters

Pf, Hoar; Rm, Wilson; Dt, Mangano; Gj, Avery; Rj, Szarnicki; Jd, Hill

doi:10.1056/nejm198110223051707

Cited by 115 publications

(20 citation statements)

References 10 publications

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“…If this is the case, the use of heparin-bonded subclavian vein catheters might decrease the incidence of subclavian vein thrombosis, as has been shown for SwanGanz catheters. 10,11 Despite the high frequency of this complication noted in our group of patients, two considerations are important. First, if given sufficient time, it appears that patients who develop subclavian vein occlusion will subsequently recanalize this vessel.…”

Section: Resultsmentioning

confidence: 90%

Subclavian Vein Stenosis as a Complication of Subclavian Catheterization for Hemodialysis

Spinowitz¹,

Galler²,

Golden³

et al. 1987

Arch Intern Med

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Section: Resultsmentioning

confidence: 90%

Subclavian Vein Stenosis as a Complication of Subclavian Catheterization for Hemodialysis

Spinowitz¹,

Galler²,

Golden³

et al. 1987

Arch Intern Med

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“…General information: The incidence of TEs secondary to peripheral arterial catheters in the absence of UFH is influenced by catheter material, 54 duration of placement, 55 diameter, 55 length, 56 solutions infused, and arterial site. 57 Acute impairment of arterial blood flow to the hand or foot is characterized by diminished or absent pulses, a prolonged capillary refill time, and a cool, pale hand or foot.…”

Section: Peripheral Arterial Cathetersmentioning

confidence: 99%

“…163 The lack of efficacy for UFH-bonded UACs may reflect the fact that the catheters were used for longer periods of time in newborns than in adults. 54 Peripheral lines: Three studies show that UFH prolongs the patency of peripheral lines. [57][58][59] Sellden et al assessed intermittent vs continuous flushing with UFH containing solutions in 338 infants less than 1 year of age with radial arterial catheters.…”

Section: Guidelines For Antithrombotic Agentsmentioning

confidence: 99%

Thromboembolic Disease and Antithrombotic Therapy in Newborns

Andrew¹,

Monagle²,

deVeber³

et al. 2001

Hematology

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This update uses an evidence based approach to analyze and present the epidemiology of neonatal thrombosis, etiologies, currently used techniques for diagnosis with their limitations, and current therapeutic approaches. In addition, the approaches to both prevention and optimal therapies are discussed.In Section I Dr. Paul Monagle addresses the epidemiology of neonatal thrombosis outside of the central nervous system in both arterial and venous locations, and those that occur in utero. The specific contributions of catheters and congenital prothrombotic disorders are delineated. Dr. Monagle also describes currently used techniques for the diagnosis of thrombotic events as well as their limitations and the current therapeutic approaches.In Section II, Dr. Gabrielle deVeber reviews the epidemiology of neonatal thrombosis within the central nervous system, in both arterial and venous locations and those that occur in utero. The neurological presentation, risk factors including congenital prothrombotic disorders, anatomical distribution, diagnostic tests, use of antithrombotic therapy and neurologic outcome of neonates with either sinovenous thrombosis or arterial ischemic stroke are discussed.In Section III, Dr. Anthony Chan reviews the current approaches to the prevention and treatment of neonatal thrombosis. Information on the differences in the response of neonates compared to adults to antithrombotic therapy and new approaches to the prevention and treatment of thrombosis in neonates are emphasized.Thromboembolic events (TEs) during childhood are increasing in their frequency and severity, and occur in children surviving previously life-threatening primary diseases. Newborns comprise the largest group of children developing TEs. This paper discusses the epidemiology, diagnostic tests, acquired and congenital prothrombotic risk factors, long-term outcomes, and antithrombotic therapy for the management of TEs in newborns. Due to the unique features and the significance of TEs in the central nervous system (CNS), sinovenous thrombosis (SVT) and arterial ischemic stroke (AIS) will be considered separately; cerebrovascular lesions in premature infants will not be discussed.In preparation for this manuscript, comprehensive Medline reviews were performed to identify all relevant publications, which were analyzed based upon the study design; results of studies with stronger designs were given more influence in the analysis. The striking features of this review were the deficiencies in our knowledge with respect to appropriate diagnostic strategies, optimal therapy for newborns with TEs, and the contribution of congenital prothrombotic disorders. Well-designed trials are required to improve our ability to care for neonates with TEs.

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“…However, the latter show superior retention. Both heparin bonding and heparin coating have been introduced as new approaches to reduce catheterinduced embolization (11).…”

Section: Discussionmentioning

confidence: 99%