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Thrombotic complications of tunneled central lines in children with malignancy
Tomasz Ociepa1, Eliza Maloney, Tomasz Urasinski
1Clinic of Pediatrics, Hematology and Pediatric Oncology, Pomeranian Medical University, Szczecin, Poland. octom@poczta.onet.pl
Background:
The total rate of thrombotic complications caused by tunneled central lines (TCL) is still not known, as are the long-term consequences.
Aim Of The Study:
Estimation of a rate of thrombotic complications in children with TCL and malignancy and Doppler ultrasound assessment of blood flow after TCL removal.
Materials And 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.
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