No effect of nadroparin prophylaxis in the prevention of central venous catheter (CVC)-associated thrombosis in bone marrow transplant recipients.
Complications of CVCs in 382 consecutive patients receiving a stem cell transplantation (SCT) were analysed. Early complications were pneumothorax (3.6%), haematothorax (0.5%), dislocation (3%) and dysfunction (3.6%). Eighty-seven-associated infections (22%) were observed, leading to removal of the CVC in 26 patients. More bacteraemias were associated with double- or triple-lumen CVCs, 19% vs 5% in single lumen CVCs (P < 0.0001). Coagulase-negative staphylococci were the predominant microorganisms in 72%. A special point of investigation was CVC-associated thrombosis and the prophylactic value of nadroparin. Two consecutive regimens with nadroparin were used and compared; 7 days 2850 IE nadroparin and 10 days 5700 IE nadroparin. The incidence of CVC-associated thrombosis was 6.9% in 382 patients with 390 catheters. The incidence was 8% in patients receiving one of the prophylactic nadroparin regimens compared to 6% in a comparable control group without prophylaxis. A short course of nadroparin was unable to prevent thrombotic complications after discontinuation.
Lagro
S W
SW
St Antonius Hospital Department of Pediatrics, Utrecht, The Netherlands.
Verdonck
L F
LF
Borel Rinkes
I H
IH
Dekker
A W
AW
D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D017762:Nadroparin / Q000627:therapeutic use*; D012189:Retrospective Studies; D013927:Thrombosis / Q000517:prevention & control*
D005343:Fibrinolytic Agents; D017762:Nadroparin