Use of heparin-coated central venous lines to prevent catheter-related bloodstream infection.
Bloodstream infections related to the use of central venous catheters are an important cause of patient morbidity, mortality, and increased health care costs. Catheter-related infection may be due to fibrin deposition associated with catheters. Interventions designed to decrease fibrin deposition have the potential to reduce catheter-related infections. This study was a randomized, controlled trial in which 246 patients with nontunneled central venous catheters were randomly assigned to receive a heparin-coated catheter with 50 mL/d of normal saline solution as a continuous infusion (heparin-coated group) or a noncoated catheter with a continuous infusion of low-dose unfractionated heparin (control group: continuous infusion of 100 U/kg/d). Catheter-related bloodstream infection occurred in 2.5% (3/120 catheters) in the heparin-coated group (0.9 events per 1,000 days) and in 9.1% (11/120 catheters) in the control group (3.5 events per 1,000 days; P = 0.027). No other risk factors were found for the development of catheter-related bloodstream infection. Six and seven patients experienced severe bleeding in the heparin-coated and control groups, respectively (P = 1.00). We did not observe heparin-induced thrombocytopenia. The use of heparin-coated catheters can be a safe and effective approach to the prevention of catheter-related bloodstream infection in patients with hematooncologic disease.
Abdelkefi
Abderrahman
A
Centre National de Greffe de Moelle Osseuse, Tu- nis, Tunisia. aabdelkefi@yahoo.fr
Achour
Wafa
W
Ben Othman
Tarek
T
Ladeb
Saloua
S
Torjman
Lamia
L
Lakhal
Amel
A
Ben Hassen
Assia
A
Hsairi
Mohamed
M
Ben Abdeladhim
Abdeladhim
A
D000293:Adolescent; D000328:Adult; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation*; D002408:Catheters, Indwelling / Q000009:adverse effects* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D020099:Coated Materials, Biocompatible / Q000627:therapeutic use*; D003428:Cross Infection / Q000517:prevention & control; D004311:Double-Blind Method; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage*; D006801:Humans; D007262:Infusions, Intravenous / Q000379:methods; D008297:Male; D008875:Middle Aged; D018805:Sepsis / Q000209:etiology / Q000517:prevention & control*
D000891:Anti-Infective Agents, Local; D000925:Anticoagulants; D020099:Coated Materials, Biocompatible; D006495:Heparin, Low-Molecular-Weight