Thrombogenicity testing of central venous cathetersin vitro

Abstract

To date there have been no standard methods for assessing the thrombogenicity of central venous catheters. A procedure for testing the thrombogenicity of intravenous lines such as the silver-impregnated catheter by continuous blood flow in vitro was therefore developed. For this test, fresh blood was drawn from healthy human donors and anti-coagulated with sodium citrate (1:9). All material tested (catheter tubes with and without silver manufactured in the same way, polyethylene tubes and tubes with potentially thrombogenic material) were perfused through their lumen with anticoagulated blood for up to 31 hours. Blood samples were collected at different times from the test system at sites before and after the perfusion of the test catheters. The hemoglobin concentration, erythrocyte, leukocyte and thrombocyte counts and markers for thrombin activation (thrombin-antithrombin III-complex, F1 + 2)-prothrombin fragments) and for hyperfibrinolysis (d-dimers) were determined. No thrombin activation or signs of hyperfibrinolysis were detected in any material tested. Polyethylene tubes were found to cause hemolysis, as shown by a decrease in hemoglobin content from 15 g% to 4.5 g%. Tecothane tubes with and without silver did not induce hemolysis.

Sonographic and Clinical Features of Upper Extremity Deep Venous Thrombosis in Critical Care Patients

“…Risk factors have been established for catheter-related DVT which include catheter material, diameter, and position of the catheter. Clinical and in vitro studies have demonstrated that both polyurethane and silicone catheters are associated with a lower rate of catheter-related DVT as compared with polyethylene or Teflon-coated catheters [16, 17]. In our study all CVCs were polyurethane.…”

“…CVCs have been increasingly used in the intensive care unit (ICU) hence there is rationale to further investigated UEDVT [11–15]. CVC-associated UEDVT may be related to the material the catheter is made of and its diameter [11–17]. Other commonly reported risk factors for development of UEDVT are malignancy and thrombophilia.…”

The influence of cerebrospinal fluid on blood coagulation and the implications for ventriculovenous shunting

“…4 In this study, Tecothane, a noncoated aromatic polyether urethane, was used. Although Tecothane is known to have a superior hemocompatibility, 5 clot formation was visualized on the surface of all shunts. Different coatings could be used to further reduce the thrombogenicity of biomaterials.…”

Current perspective of venous thrombosis in the upper extremity

“…The risk of thrombosis is dependent on the diameter of the catheter; a larger diameter gives a higher risk of thrombosis [30]. The risk of UEDVT is lower for polyurethane and silicone catheters compared with polyethylene or Teflon‐coated catheters [38,39].…”