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Central venous catheterization in patients with coagulopathy
P F Foster1, L R Moore, H N Sankary
1Department of General Surgery, Rush-Presbyterian-St Luke's Medical Center, Chicago, IL 60612.
Archives of Surgery (Chicago, Ill. : 1960)
|March 1, 1992
Summary
Percutaneous central venous catheterization is safe in patients with coagulopathy. Experienced clinicians can perform these procedures without serious bleeding complications, even without correcting abnormal coagulation parameters.
Area of Science:
- Vascular Surgery
- Transplant Surgery
- Critical Care Medicine
Background:
- Coagulopathy is common in liver transplant recipients.
- Central venous catheterization is essential for managing these patients.
- The risk of bleeding during catheterization in coagulopathic patients is a concern.
Purpose of the Study:
- To evaluate the risk of bleeding complications during percutaneous central venous catheterization in patients with coagulopathy.
- To determine the safety of central venous catheterization in liver transplant recipients with abnormal coagulation parameters.
Main Methods:
- Retrospective analysis of 259 percutaneous central venous catheterizations in 40 liver transplant recipients.
- Focus on 202 catheterizations performed in patients with documented coagulopathy (abnormal prothrombin times, activated partial thromboplastin times, and/or platelet counts).
- No correction of coagulopathy prior to or during procedures.
Main Results:
- No serious bleeding complications occurred during any of the 259 catheterizations.
- This finding held true for the 202 procedures performed in patients with coagulopathy.
- No interventions were made to correct coagulation parameters.
Conclusions:
- Percutaneous central venous catheterization can be performed safely in patients with coagulopathy.
- Experienced clinicians can minimize bleeding risks using appropriate techniques.
- Correction of coagulopathy is not always necessary before central venous catheterization.