Prophylaxis with urokinase in pediatric oncology patients with central venous catheters.
This study evaluated the effects of urokinase in the prevention of central venous catheter (CVC)-related complications in children with malignancy. Fifteen patients with 16 CVCs (study group A) received an intraluminal application of urokinase (10,000 IU in each catheter lumen for 4 h) once a week. They were monitored prospectively with quantitative blood cultures and ultrasonography (color Doppler ultrasound of the great veins and echocardiography). The rate of complications was compared with that of 15 children with 19 CVCs without thromboprophylaxis, treated the previous significantly lower incidence of CVC dysfunction year (control group B). The authors found a wer incidence of CVC dysfunction (3/16 versus 13/19), no major thrombosis, fewer CVC-related bacteremias (2/16 versus 8/19), and a higher salvage of CVCs (1/16 versus 5/19 CVC removals due to persistent bacteremia) in the thromboprophylaxis group. Asymptomatic thrombosis rate was also lower (7/16 cases in group A versus 9/11 in group B when sonography was performed). No hemorrhagic complications were noted. Thromboprophylaxis with urokinase seems a safe and effective measure for reducing the rate of CVC-related complications.
Kalmanti
Maria
M
Department of Pediatric Hematology/Oncology, University Hospital of Heraklion, Crete, Greece. pedhem@med.uoc.gr
Germanakis
John
J
Stiakaki
Eftichia
E
Syfridaki
Cathrin
C
Christidou
Athanasia
A
Tsetis
Dimitris
D
Vardas
Panagiotis
P
Charisis
George
G
D016470:Bacteremia / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000628:therapy; D010960:Plasminogen Activators / Q000008:administration & dosage* / Q000627:therapeutic use; D011446:Prospective Studies; D013927:Thrombosis / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage* / Q000627:therapeutic use / Q000633:toxicity
D010960:Plasminogen Activators; D014568:Urokinase-Type Plasminogen Activator