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Prevention of central venous catheter-associated thrombosis: a meta-analysis

Angelia Kirkpatrick1, Suman Rathbun, Thomas Whitsett

  • 1Department of Medicine, Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA. akirkpat@ouhsc.edu

The American Journal of Medicine
|October 2, 2007
PubMed

Insights

Anticoagulant prophylaxis effectively prevents all catheter-associated deep vein thrombosis in patients with central venous catheters. However, its benefit for symptomatic venous thromboembolism remains uncertain.

Area of Science:

  • Vascular Medicine
  • Pharmacology
  • Clinical Trials

Background:

  • Central venous catheters are essential but increase deep vein thrombosis (DVT) risk.
  • Prophylaxis with anticoagulants is debated for catheter-associated DVT.

Purpose of the Study:

  • To evaluate the efficacy of anticoagulant prophylaxis in preventing DVT in patients with central venous catheters.
  • To synthesize evidence from randomized controlled trials (RCTs).

Main Methods:

  • Meta-analysis of 15 randomized controlled trials.
  • Searched MEDLINE, EMBASE, conference proceedings, and bibliographies up to May 2006.
  • Evaluated unfractionated heparin, vitamin K antagonists, and low-molecular-weight heparin.

Main Results:

  • Anticoagulant prophylaxis significantly reduced all catheter-associated DVTs (relative risks 0.31-0.73).
  • Significant reduction was observed for symptomatic and asymptomatic DVTs combined.
  • Effectiveness for symptomatic DVT alone did not reach statistical significance for individual regimens.

Conclusions:

  • Anticoagulant prophylaxis is effective in preventing all catheter-associated DVTs.
  • The role of prophylaxis in preventing symptomatic venous thromboembolism, including pulmonary embolism, requires further investigation.
Abstract

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