Use of heparin versus lepirudin flushes to prevent withdrawal occlusion of central venous access devices

Pharmacotherapy

Volumn 26, Issue 9 I, 2006, Pages 1262-1267

  Horne III, McDonald K ^a,b   McCloskey, Donna Jo ^a   Calis, Karim ^b   Wesley, Robert ^b   Childs, Richard ^c   Kasten Sportes, Claude ^d  

^a W G Magnuson Clinical Center   (United States)

^b NATIONAL INSTITUTES OF HEALTH   (United States)

^c NATIONAL HEART LUNG AND BLOOD INSTITUTE   (United States)

^d NATIONAL CANCER INSTITUTE   (United States)

Author keywords

Catheter function; Heparin; Lepirudin; Venous access device; Withdrawal occlusion

Indexed keywords

ALTEPLASE; ANTIBIOTIC AGENT; ANTICOAGULANT AGENT; DRUG ANTIBODY; HEPARIN; LEPIRUDIN;

ADULT; ANTIBODY BLOOD LEVEL; ARTICLE; BLEEDING DISORDER; BONE MARROW TRANSPLANTATION; CANCER THERAPY; CATHETER OCCLUSION; CENTRAL VENOUS CATHETER; CENTRAL VENOUS CATHETERIZATION; CLINICAL ARTICLE; CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; DEVICE; DOUBLE BLIND PROCEDURE; DRUG INSTILLATION; DRUG WITHDRAWAL; HEMATOLOGIC MALIGNANCY; HUMAN; METASTASIS; PARTIAL THROMBOPLASTIN TIME; RANDOMIZED CONTROLLED TRIAL; RISK FACTOR; SOLID TUMOR; VEIN OCCLUSION;

ANTICOAGULANTS; BONE MARROW TRANSPLANTATION; CATHETERIZATION, CENTRAL VENOUS; DOUBLE-BLIND METHOD; FEMALE; FIBRINOLYTIC AGENTS; HEPARIN; HIRUDINS; HUMANS; MALE; MIDDLE AGED; RECOMBINANT PROTEINS; THROMBOSIS; TISSUE PLASMINOGEN ACTIVATOR;

EID: 33748109233     PISSN: 02770008     EISSN: None     Source Type: Journal    
DOI: 10.1592/phco.26.9.1262     Document Type: Article

References (24)

1. Tschihart JM, Rao MK. Mechanism and management of persistent withdrawal occlusion. Am Surg 1988;54:326-8.
2. Raad II, Luna M, Khalil S-AM, Costerton JW, Lam C, Bodey GP. The relationship between the thrombotic and infectious complications of central venous catheters. JAMA 1994;271:1014-16.
3. Polderman KH, Girbes ARJ. Central venous catheter use. Part 1: mechanical complications. Intensive Care Med 2002;28:1-17.
4. Randolph AG, Cook DJ, Gonzales CA, Andrew M. Benefit of heparin in central venous and pulmonary artery catheters. Chest 1998;113:165-71.
5. Goode CJ, Titler M, Rakel B, et al. A meta-analysis of effects of heparin flush and saline flush: quality and cost implications. Nurs Res 1991;40:324-30.
6. Rabe C, Gramann T, Sons X, et al. Keeping central venous lines open: a prospective comparison of heparin, vitamin C and sodium chloride sealing solutions in medical patients. Intensive Care Med 2002;28:1172-6.
7. Abdelkefi A, Othman TB, Kammun L, et al. Prevention of central venous line-related thrombosis by continuous infusion of low-dose unfractionated heparin in patients with haematooncological disease. Thromb Haemost 2004;92:654-61.
8. Kadidal VV, Mayo DJ, Horne MK. Heparin-induced thrombocytopenia (HIT) due to heparin flushes: a report of three cases. J Intern Med 1999;246:325-9.
9. Mayo DJ, Cullinane AM, Merryman PK, Horne MK. Serologic evidence of heparin sensitization in cancer patients receiving heparin flushes of venous access devices. Support Care Cancer 1999;7:425-7.
10. Greinacher A, Eichler P, Lubenow N, Kwasny H, Luz M. Heparin-induced thrombocytopenia with thromboembolic complications: meta-analysis of two prospective trials to assess the value of parenteral treatment with lepirudin and its therapeutic aPTT range. Blood 2000;96:846-51.
11. Weitz JI, Hudoba M, Massel D, Maraganore J, Hirsh J. Clot-bound thrombin is protected from inhibition by heparin-antithrombin III but is susceptible to inactivation by antithrombin III-independent inhibitors. J Clin Invest 1990;86:385-91.
12. Braun PJ, Dennis S, Hofsteenge J, Stone SR. Use of site-directed mutagenesis to investigate the basis for the specificity of hirudin. Biochemistry 1998;27:6517-22.
13. Agnelli G, Renga C, Weitz JI, Nenci GG, Hirsh, J. Sustained antithrombotic activity of hirudin after its plasma clearance: comparison with heparin. Blood 1992;80:960-5.
14. Horne MK, Brokaw KJ. Antithrombin activity of lepirudin adsorbed to silicone (polydimethylsiloxane) tubing. Thromb Res 2003;112:111-15.
15. Horne MK, Inkellis E. Retention of lepirudin at the tip of a silicone catheter: a better catheter flush solution? Support Care Cancer 2004;12:278-81.
16. Nejad MS, Klaper MA, Steggerda FR, Gianturco C. Clotting on the outer surfaces of vascular catheters. Radiology 1968;91:248-50.
17. Xiang DZ, Verbeken EK, Van Lommel ATL, Stas M, De Wever I. Composition and formation of the sleeve enveloping a central venous catheter. J Vasc Surg 1998;28:260-71.
18. O'Farrell L, Griffith JW, Lang CM. Histologic development of the sheath that forms around long-term implanted central venous catheters. J Parenter Enteral Nutr 1996;20:156-8.
19. Gimbrone MA. Vascular endothelium: nature's blood-compatible container. Ann N Y Acad Sci 1987;516:5-11.
20. Markwardt F, Nowak G, Sturzebecher J, Vogel G. Clinicopharmacological studies with recombinant hirudin. Thromb Res 1988;52:393-400.
21. Nowak G, Bucha E, Goock T, Thieler H, Markwardt F. Pharmacology of r-hirudin in renal impairment. Thromb Res 1992;66:707-15.
22. Welling PG. Pharmacokinetics: processes, mathematics, and applications, 2nd ed. Washington, DC: American Chemical Society, 1997.
23. Semba CP, Deitcher SR, Li X, Resnansky L, Tu T, McCluskey ER. Treatment of occluded central venous catheters with alteplase: results in 1064 patients. J Vasc Interv Radiol 2002;13:1199-205.
24. Eichler P, Friesen H-J, Lubenow N, Jaeher B, Greinacher A. Antihirudin antibodies in patients with heparin-induced thrombocytopenia treated with lepirudin: incidence, effects on aPTT, and clinical relevance. Blood 2000;96:2373-8.