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[Treatment of obstruction and thrombosis due to central venous catheterization]
1Universitätskinderklinik Freiburg.
Thrombolytic treatment with urokinase (5000 U/ml) or streptokinase can restore patency in central venous catheters occluded by thrombosis. In pediatric patients preferable urokinase should be used. The therapy in case of catheter-induced central venous thrombosis is a continuous urokinase infusion (125,000 U/1.73(2)/h) for about 3 to 8 days, followed by a long-term heparinization. The treatment in persistent withdrawal occlusion is significantly shorter, a few hours of systemic lysis are sufficient. The treatment of choice in case of chemical obstructions in patients with long-term parenteral nutrition is the injection of 0.1 N HCl in combination with Heparin. By these procedures most of obstructed central venous catheters can be reopened and maintained in place. This preserves the count of possible catheter implantation sites.
Thrombolytic treatment with urokinase (5000 U/ml) or streptokinase can restore patency in central venous catheters occluded by thrombosis. In pediatric patients preferable urokinase should be used. The therapy in case of catheter-induced central venous thrombosis is a continuous urokinase infusion (125,000 U/1.73(2)/h) for about 3 to 8 days, followed by a long-term heparinization. The treatment in persistent withdrawal occlusion is significantly shorter, a few hours of systemic lysis are sufficient. The treatment of choice in case of chemical obstructions in patients with long-term parenteral nutrition is the injection of 0.1 N HCl in combination with Heparin. By these procedures most of obstructed central venous catheters can be reopened and maintained in place. This preserves the count of possible catheter implantation sites.