Thromboembolic complications related to indwelling central venous catheters in children with oncological/haematological diseases: A retrospective study of 362 catheters

A. Molinari, E. Castagnola, C. Mazzola, M. Piacentino, G. Fratino

Research output: Contribution to journalArticle

Abstract

Indwelling central venous catheters (CVC) are essential devices in the management of children with oncological/haematological diseases being treated with chemotherapy or undergoing bone marrow transplantation. Our study was aimed at detecting the incidence of important thrombotic events caused by CVC in children, and the coexistence of coagulation disorders in children affected with thromboembolic disease related to CVC. Therefore, we describe some antithrombotic strategies which have been successfully applied to solve functioning problems of correctly inserted CVC. We retrospectively evaluated the clinical records of 308 children (age range 2 months to 14 years) with oncological/haematological diseases undergoing insertion of 362 indwelling CVC from January 1994 to December 1998 at the Gaslini Children's Hospital. We collected data on seven serious asymptomatic thrombotic episodes diagnosed between 1994 and 1998 following catheter malfunctioning and one case of suspected lung embolism with symptoms. Coagulation tests allowed us to identify one case of probable heterozygosis of Protein C deficiency and one case of G20210A prothrombotic prothrombin mutation. This finding suggests the need for further evaluation for thrombophilia in all patients presenting with thrombotic complications of CVC. We therefore emphasise the importance of prophylaxis with low-dose heparin in children with malignancies receiving CVC. A prospective study, which has already been started, should identify the exact role of thromboembolic complications in children with indwelling CVC for oncological/haematological malignancies.

Original languageEnglish
Pages (from-to)539-544
Number of pages6
JournalSupportive Care in Cancer
Volume9
Issue number7
DOIs
Publication statusPublished - 2001

Fingerprint

Indwelling Catheters
Central Venous Catheters
Hematologic Diseases
Catheters
Retrospective Studies
Protein C Deficiency
Thrombophilia
Prothrombin
Hematologic Neoplasms
Embolism
Bone Marrow Transplantation
Heparin
Prospective Studies
Drug Therapy
Equipment and Supplies
Lung
Mutation
Incidence

Keywords

  • Central venous catheters
  • Oncological/haematological diseases
  • Paediatric patients
  • Thrombosis

ASJC Scopus subject areas

  • Oncology
  • Nursing(all)

Cite this

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abstract = "Indwelling central venous catheters (CVC) are essential devices in the management of children with oncological/haematological diseases being treated with chemotherapy or undergoing bone marrow transplantation. Our study was aimed at detecting the incidence of important thrombotic events caused by CVC in children, and the coexistence of coagulation disorders in children affected with thromboembolic disease related to CVC. Therefore, we describe some antithrombotic strategies which have been successfully applied to solve functioning problems of correctly inserted CVC. We retrospectively evaluated the clinical records of 308 children (age range 2 months to 14 years) with oncological/haematological diseases undergoing insertion of 362 indwelling CVC from January 1994 to December 1998 at the Gaslini Children's Hospital. We collected data on seven serious asymptomatic thrombotic episodes diagnosed between 1994 and 1998 following catheter malfunctioning and one case of suspected lung embolism with symptoms. Coagulation tests allowed us to identify one case of probable heterozygosis of Protein C deficiency and one case of G20210A prothrombotic prothrombin mutation. This finding suggests the need for further evaluation for thrombophilia in all patients presenting with thrombotic complications of CVC. We therefore emphasise the importance of prophylaxis with low-dose heparin in children with malignancies receiving CVC. A prospective study, which has already been started, should identify the exact role of thromboembolic complications in children with indwelling CVC for oncological/haematological malignancies.",
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AU - Castagnola, E.

AU - Mazzola, C.

AU - Piacentino, M.

AU - Fratino, G.

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