Prevention of central venous catheter associated thrombosis using minidose warfarin in patients with haematological malignancies.
Thrombosis is a well-recognized complication following insertion of central venous catheters and is associated with significant morbidity. In an attempt to reduce line-associated thrombosis, 108 consecutive patients with haematological malignancies were commenced on prophylactic 'minidose' warfarin, 1 mg/d, at the time of line insertion. This group of patients were compared with a historic group of 115 consecutive patients who had not received warfarin. Clinically-suspected venous thrombosis was confirmed by Doppler ultrasound or venography. Patients taking prophylactic warfarin had their prothrombin time measured three times per week with the aim of maintaining an INR <1.6. Five (5%) of the 108 patients who received minidose warfarin developed a thrombosis, at a median of 72 d (range 5-166) from the time of catheter insertion. In the 115 patients who were not anticoagulated 15 (13%) developed a catheter-associated thrombosis at a median of 16 d (range 1-35). There was a significant reduction in line-associated thrombosis in patients receiving warfarin (P=0.03). These data suggest that minidose warfarin reduces the incidence of central venous catheter related thrombosis in patients with haematological malignancies.
Boraks
P
P
BMT Unit, Addenbrooke's NHS Trust, Cambridge.
Seale
J
J
Price
J
J
Bass
G
G
Ethell
M
M
Keeling
D
D
Mahendra
P
P
Baglin
T
T
Marcus
R
R
D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000009:adverse effects; D019337:Hematologic Neoplasms / Q000188:drug therapy*; D006801:Humans; D012189:Retrospective Studies; D013350:Subclavian Vein; D013927:Thrombosis / Q000517:prevention & control*; D013997:Time Factors; D014859:Warfarin / Q000008:administration & dosage*
D000925:Anticoagulants; D014859:Warfarin