Thromboembolic complications related to indwelling central venous catheters in children.
OBJECTIVE
Thrombosis is one of the most frequent complications of indwelling central venous catheters. During the past year, new information has emerged regarding the incidence and predisposing factors of thromboembolic complications of indwelling central venous catheters. Because indwelling central venous catheters are widely used, it is important to be aware of new information regarding thromboembolic complications of these devices.


RESULTS
Recent studies have better defined the risks of thromboembolic complications in patients with cancer with indwelling central venous catheters. Acquired hypercoagulable disorders such as heparin-induced thrombocytopenia, antiphospholipid syndrome, and therapy with asparaginase are associated with thromboembolic disorders in patients with indwelling central venous catheters. Studies analyzing the association between inherited hypercoagulable disorders and thrombosis have shown conflicting results. Preliminary studies suggest that low molecular weight heparins could have a role in the prevention of catheter-related thromboembolic disorders. Nevertheless, larger prospective studies will be necessary to determine the role of anticoagulants in the prevention of thromboembolic disorders in patients with cancer with indwelling central venous catheters.


CONCLUSIONS
Recent reports will facilitate the evaluation and risk assessment of children with cancer who have indwelling central venous catheters. Despite these advances, large, controlled studies focusing on specific populations of patients, such as children, should be undertaken to determine the true performance and optimal use of indwelling central venous catheters. Future studies should also address better ways to prevent catheter-related thrombosis and infection.
Freytes
César O
CO
University of Texas Health Science Center at San Antonio, Mail Code 7880, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA. freytes@uthscsa.edu
D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D002648:Child; D006801:Humans; D009369:Neoplasms / Q000150:complications* / Q000628:therapy; D013923:Thromboembolism / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*