title: Thrombotic complications of tunneled central lines in children with malignancy.
abstract: BACKGROUND
  The total rate of thrombotic complications caused by tunneled central lines (TCL) is still not known, as are the long-term consequences.
  
  
  OBJECTIVE
  Estimation of a rate of thrombotic complications in children with TCL and malignancy and Doppler ultrasound assessment of blood flow after TCL removal.
  
  
  METHODS
  One hundred twenty-four children were enrolled for the study. Heparin lock was used as a prophylaxis for line occlusion. The rate and type of thrombotic events associated with TCL were analyzed in all patients. In children without an earlier history of thrombosis, a Doppler ultrasound examination was carried out after TCL removal.
  
  
  RESULTS
  In 45.2% of patients at least 1 thrombotic event occurred. These events were TCL lumen thrombosis (42.8% of patients) and subclavian vein thrombosis (2.4% of patients). In 37 patients Doppler ultrasound was carried out and revealed an abnormal blood flow in the vein that was examined in 59.5% of them.
  
  
  CONCLUSIONS
  The total rate of thrombotic complications in children with TCL and malignancy is high. A substantial proportion of thrombotic complications can be clinically silent. The use of a heparin lock once a week seems far from effective in preventing thrombotic events in patients with TCL. The TCL life span has no influence on the rate of thrombotic events.
authors.affiliation: Clinic of Pediatrics, Hematology and Pediatric Oncology, Pomeranian Medical University, Szczecin, Poland. octom@poczta.onet.pl
authors.forename: Tomasz
authors.initials: T
authors.lastname: Ociepa
authors.forename: Eliza
authors.initials: E
authors.lastname: Maloney
authors.forename: Tomasz
authors.initials: T
authors.lastname: Urasinski
authors.forename: Marcin
authors.initials: M
authors.lastname: Sawicki
mesh_terms: D000293:Adolescent; D001215:Asparaginase / Q000009:adverse effects; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000628:therapy*; D013927:Thrombosis / Q000209:etiology*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D020246:Venous Thrombosis / Q000209:etiology
chemical_list: D010959:Tissue Plasminogen Activator; D001215:Asparaginase