Central catheter fibrin sleeve--heparin effect

Area of Science:

• Vascular Surgery
• Critical Care Medicine
• Medical Device Technology

Background:

• Central venous catheters are essential for intravenous therapy but associated with intravascular abnormalities.
• Fibrin sleeve formation is a known complication, potentially impacting catheter function and patient outcomes.
• The efficacy of low-dose heparin in preventing these complications with silicone catheters requires further investigation.

Purpose of the Study:

• To determine the incidence of intravascular abnormalities with silicone central venous catheters.
• To evaluate the effect of low-dose heparin on fibrin sleeve formation.
• To assess the relationship between catheter dwell time and intravascular reactions.

Main Methods:

• Prospective randomized study involving 34 patients receiving silicone central venous catheters for nutritional support.
• Patients were randomized to receive either 1000 units of heparin per liter of infusate or no heparin.
• Catheter venograms were performed post-therapy to assess for intravascular abnormalities.

Main Results:

• Fibrin sleeve formation occurred in 53% of patients receiving heparin and 65% of the control group.
• The duration of catheterization correlated significantly with the incidence of fibrin sleeve formation.
• No cases of central venous thrombosis were observed in patients with silicone catheters, despite fibrin sleeve presence.

Conclusions:

• Intravascular reactions, including fibrin sleeve formation, are common with central venous catheters regardless of material.
• Low-dose heparin does not significantly reduce the incidence of fibrin sleeve formation.
• Silicone catheters appear to be associated with a low risk of central venous thrombosis, even in the presence of fibrin sleeves.