Catheter-related thrombosis in hematologic patients.
For many years central venous catheters (CVC) have been utilized to monitor hemodynamics and to deliver parenteral nutrition, blood products, pharmacological therapies or infusion fluids. Recently, CVC use has greatly increased with significant impact on the administration of chemotherapy, stem cell transplantation and other treatments to cancer patients. However, CVC use may be accompanied by a variety of side-effects, which increase with the duration of implantation. The most common catheter-related complications are thrombotic events and blood-stream infections. The true incidence of these complications is still uncertain and has changed over time due to CVC device improvement. More data are available in solid tumor than in oncohematologic patients. Recently, much attention has been paid to the issues of prevention and treatment of these complications. Some strategies have been proposed: fixed dose warfarin or low molecular weight heparins have been evaluated in some clinical trials of thromboprophylaxis in this condition. However, more studies are still needed to address this issue. This review will focus on CVC use and complications in oncohematologic patients.
Moia
Marco
M
Angelo Bianchi Bonomi Hemophilia and Thrombosis Center and Department of Hematology, IRCCS Maggiore Hospital and University of Milan, Milan, Italy.
Cortelezzi
Agostino
A
Falanga
Anna
A
D002405:Catheterization, Central Venous / Q000009:adverse effects*; D019337:Hematologic Neoplasms / Q000150:complications*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D018805:Sepsis / Q000209:etiology; D013927:Thrombosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D014859:Warfarin / Q000627:therapeutic use
D006495:Heparin, Low-Molecular-Weight; D014859:Warfarin