Randomized Trial of Prevention of Catheter-Related Bloodstream Infection by Continuous Infusion of Low-Dose Unfractionated Heparin in Patients With Hematologic and Oncologic Disease
Infection is a serious complication of central venous catheters in immunocompromised patients. Catheter-related infection may be caused by fibrin deposition associated with catheters. Interventions designed to decrease fibrin deposition have the potential to reduce catheter-related infections. The p...
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| Veröffentlicht in: | Journal of clinical oncology 2005-11, Vol.23 (31), p.7864-7870 |
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| creator | ABDELKEFI, Abderrahman TORJMAN, Lamia LADEB, Saloua BEN OTHMAN, Tarek ACHOUR, Wafa LAKHAL, Amel HSAIN, Mohamed KAMMOUN, Leila BEN HASSEN, Assia BEN ABDELADHIM, Abdeladhim |
| description | Infection is a serious complication of central venous catheters in immunocompromised patients. Catheter-related infection may be caused by fibrin deposition associated with catheters. Interventions designed to decrease fibrin deposition have the potential to reduce catheter-related infections. The purpose of this study was to evaluate the role of low-dose unfractionated heparin in preventing catheter-related bloodstream infection in patients with hemato-oncological disease.
This study was a randomized, controlled trial in which patients with nontunneled catheters were randomly assigned to receive either intravenous unfractionated heparin (continuous infusion of 100 U/kg per day) or 50 mL/day of normal saline solution as a continuous infusion (control group). Heparin was continued until the day of discharge. Catheter-related bloodstream infection was defined according to Infectious Disease Society of America guidelines.
Two hundred and eight patients were randomly assigned. Four patients were excluded after assignment. Ultimately, 204 patients were analyzed. Catheter-related bloodstream infection occurred in 6.8% (7 of 102 catheters) of those in the heparin group (2.5 events per 1,000 days) and in 16.6% (17 of 102 catheters) of those in the control group (6.4 events per 1,000 days) (P = .03). No other risk factors were found for the development of catheter-related bloodstream infection. Four and five patients experienced severe bleeding in the heparin and control groups, respectively (P = .2). We did not observe heparin-induced thrombocytopenia.
The use of continuous infusion of low-dose unfractionated heparin (100 U/kg per day) can be a practical and economical approach to the prevention of catheter-related bloodstream infection in patients with hemato-oncological disease. |
| doi_str_mv | 10.1200/JCO.2004.00.9787 |
| format | Article |
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This study was a randomized, controlled trial in which patients with nontunneled catheters were randomly assigned to receive either intravenous unfractionated heparin (continuous infusion of 100 U/kg per day) or 50 mL/day of normal saline solution as a continuous infusion (control group). Heparin was continued until the day of discharge. Catheter-related bloodstream infection was defined according to Infectious Disease Society of America guidelines.
Two hundred and eight patients were randomly assigned. Four patients were excluded after assignment. Ultimately, 204 patients were analyzed. Catheter-related bloodstream infection occurred in 6.8% (7 of 102 catheters) of those in the heparin group (2.5 events per 1,000 days) and in 16.6% (17 of 102 catheters) of those in the control group (6.4 events per 1,000 days) (P = .03). No other risk factors were found for the development of catheter-related bloodstream infection. Four and five patients experienced severe bleeding in the heparin and control groups, respectively (P = .2). We did not observe heparin-induced thrombocytopenia.
The use of continuous infusion of low-dose unfractionated heparin (100 U/kg per day) can be a practical and economical approach to the prevention of catheter-related bloodstream infection in patients with hemato-oncological disease.</description><identifier>ISSN: 0732-183X</identifier><identifier>EISSN: 1527-7755</identifier><identifier>DOI: 10.1200/JCO.2004.00.9787</identifier><identifier>PMID: 16258088</identifier><language>eng</language><publisher>Baltimore, MD: American Society of Clinical Oncology</publisher><subject>Adolescent ; Adult ; Anti-Infective Agents - economics ; Anti-Infective Agents - therapeutic use ; Biological and medical sciences ; Catheterization, Central Venous - adverse effects ; Catheters, Indwelling - adverse effects ; Catheters, Indwelling - microbiology ; Child ; Child, Preschool ; Female ; Hematologic Neoplasms - complications ; Hematologic Neoplasms - microbiology ; Hematologic Neoplasms - therapy ; Heparin, Low-Molecular-Weight - administration & dosage ; Humans ; Incidence ; Infusions, Intravenous ; Male ; Medical sciences ; Middle Aged ; Prospective Studies ; Risk Factors ; Sepsis - microbiology ; Sepsis - prevention & control ; Tumors</subject><ispartof>Journal of clinical oncology, 2005-11, Vol.23 (31), p.7864-7870</ispartof><rights>2006 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c359t-5e541143f7efc60c060b5976d407358cf14de5a641788fc131518db44d46fbbd3</citedby><cites>FETCH-LOGICAL-c359t-5e541143f7efc60c060b5976d407358cf14de5a641788fc131518db44d46fbbd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,3729,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17281539$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16258088$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>ABDELKEFI, Abderrahman</creatorcontrib><creatorcontrib>TORJMAN, Lamia</creatorcontrib><creatorcontrib>LADEB, Saloua</creatorcontrib><creatorcontrib>BEN OTHMAN, Tarek</creatorcontrib><creatorcontrib>ACHOUR, Wafa</creatorcontrib><creatorcontrib>LAKHAL, Amel</creatorcontrib><creatorcontrib>HSAIN, Mohamed</creatorcontrib><creatorcontrib>KAMMOUN, Leila</creatorcontrib><creatorcontrib>BEN HASSEN, Assia</creatorcontrib><creatorcontrib>BEN ABDELADHIM, Abdeladhim</creatorcontrib><title>Randomized Trial of Prevention of Catheter-Related Bloodstream Infection by Continuous Infusion of Low-Dose Unfractionated Heparin in Patients With Hematologic and Oncologic Disease</title><title>Journal of clinical oncology</title><addtitle>J Clin Oncol</addtitle><description>Infection is a serious complication of central venous catheters in immunocompromised patients. Catheter-related infection may be caused by fibrin deposition associated with catheters. Interventions designed to decrease fibrin deposition have the potential to reduce catheter-related infections. The purpose of this study was to evaluate the role of low-dose unfractionated heparin in preventing catheter-related bloodstream infection in patients with hemato-oncological disease.
This study was a randomized, controlled trial in which patients with nontunneled catheters were randomly assigned to receive either intravenous unfractionated heparin (continuous infusion of 100 U/kg per day) or 50 mL/day of normal saline solution as a continuous infusion (control group). Heparin was continued until the day of discharge. Catheter-related bloodstream infection was defined according to Infectious Disease Society of America guidelines.
Two hundred and eight patients were randomly assigned. Four patients were excluded after assignment. Ultimately, 204 patients were analyzed. Catheter-related bloodstream infection occurred in 6.8% (7 of 102 catheters) of those in the heparin group (2.5 events per 1,000 days) and in 16.6% (17 of 102 catheters) of those in the control group (6.4 events per 1,000 days) (P = .03). No other risk factors were found for the development of catheter-related bloodstream infection. Four and five patients experienced severe bleeding in the heparin and control groups, respectively (P = .2). We did not observe heparin-induced thrombocytopenia.
The use of continuous infusion of low-dose unfractionated heparin (100 U/kg per day) can be a practical and economical approach to the prevention of catheter-related bloodstream infection in patients with hemato-oncological disease.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Anti-Infective Agents - economics</subject><subject>Anti-Infective Agents - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Catheterization, Central Venous - adverse effects</subject><subject>Catheters, Indwelling - adverse effects</subject><subject>Catheters, Indwelling - microbiology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Hematologic Neoplasms - complications</subject><subject>Hematologic Neoplasms - microbiology</subject><subject>Hematologic Neoplasms - therapy</subject><subject>Heparin, Low-Molecular-Weight - administration & dosage</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infusions, Intravenous</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Sepsis - microbiology</subject><subject>Sepsis - prevention & control</subject><subject>Tumors</subject><issn>0732-183X</issn><issn>1527-7755</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkVFvFCEQxzdGY8_qu0-GF_VpT1hg4R51a23NJdc0bfSNsOzQo9ldTuBs6vfq95O926QJyTDwm__A_IviPcFLUmH85WezWebIlhgvV0KKF8WC8EqUQnD-slhgQauSSPr7pHgT4z3GhEnKXxcnpK64xFIuiqdrPXZ-cP-gQzfB6R55i64C_IUxOT9OWaPTFhKE8hp6nTL3rfe-iymAHtDlaMEcyPYRNT4XjXu_j9P5Ps4Ca_9QnvkI6Ha0QR_og84F7HRwI8rrSieXO0b0y6Vtvhh08r2_cwbl56HNaObszEXQEd4Wr6zuI7yb42lxe_79prko15sfl83XdWkoX6WSA2eEMGoFWFNjg2vc8pWoO5Ynw6WxhHXAdc2IkNIaQgknsmsZ61ht27ajp8Wno-4u-D97iEkNLhroez1C_qWqpWCMi1UG8RE0wccYwKpdcIMOj4pgNVmlslVqskrl_WRVLvkwa-_bAbrngtmbDHycAR2N7vPoRuPiMycqSTiden8-clt3t31wAVQcdN9n2UrdG19RRYkSsmb0PzNqrLU</recordid><startdate>20051101</startdate><enddate>20051101</enddate><creator>ABDELKEFI, Abderrahman</creator><creator>TORJMAN, Lamia</creator><creator>LADEB, Saloua</creator><creator>BEN OTHMAN, Tarek</creator><creator>ACHOUR, Wafa</creator><creator>LAKHAL, Amel</creator><creator>HSAIN, Mohamed</creator><creator>KAMMOUN, Leila</creator><creator>BEN HASSEN, Assia</creator><creator>BEN ABDELADHIM, Abdeladhim</creator><general>American Society of Clinical Oncology</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20051101</creationdate><title>Randomized Trial of Prevention of Catheter-Related Bloodstream Infection by Continuous Infusion of Low-Dose Unfractionated Heparin in Patients With Hematologic and Oncologic Disease</title><author>ABDELKEFI, Abderrahman ; TORJMAN, Lamia ; LADEB, Saloua ; BEN OTHMAN, Tarek ; ACHOUR, Wafa ; LAKHAL, Amel ; HSAIN, Mohamed ; KAMMOUN, Leila ; BEN HASSEN, Assia ; BEN ABDELADHIM, Abdeladhim</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c359t-5e541143f7efc60c060b5976d407358cf14de5a641788fc131518db44d46fbbd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Anti-Infective Agents - economics</topic><topic>Anti-Infective Agents - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Catheterization, Central Venous - adverse effects</topic><topic>Catheters, Indwelling - adverse effects</topic><topic>Catheters, Indwelling - microbiology</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>Hematologic Neoplasms - complications</topic><topic>Hematologic Neoplasms - microbiology</topic><topic>Hematologic Neoplasms - therapy</topic><topic>Heparin, Low-Molecular-Weight - administration & dosage</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infusions, Intravenous</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Sepsis - microbiology</topic><topic>Sepsis - prevention & control</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>ABDELKEFI, Abderrahman</creatorcontrib><creatorcontrib>TORJMAN, Lamia</creatorcontrib><creatorcontrib>LADEB, Saloua</creatorcontrib><creatorcontrib>BEN OTHMAN, Tarek</creatorcontrib><creatorcontrib>ACHOUR, Wafa</creatorcontrib><creatorcontrib>LAKHAL, Amel</creatorcontrib><creatorcontrib>HSAIN, Mohamed</creatorcontrib><creatorcontrib>KAMMOUN, Leila</creatorcontrib><creatorcontrib>BEN HASSEN, Assia</creatorcontrib><creatorcontrib>BEN ABDELADHIM, Abdeladhim</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of clinical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>ABDELKEFI, Abderrahman</au><au>TORJMAN, Lamia</au><au>LADEB, Saloua</au><au>BEN OTHMAN, Tarek</au><au>ACHOUR, Wafa</au><au>LAKHAL, Amel</au><au>HSAIN, Mohamed</au><au>KAMMOUN, Leila</au><au>BEN HASSEN, Assia</au><au>BEN ABDELADHIM, Abdeladhim</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Randomized Trial of Prevention of Catheter-Related Bloodstream Infection by Continuous Infusion of Low-Dose Unfractionated Heparin in Patients With Hematologic and Oncologic Disease</atitle><jtitle>Journal of clinical oncology</jtitle><addtitle>J Clin Oncol</addtitle><date>2005-11-01</date><risdate>2005</risdate><volume>23</volume><issue>31</issue><spage>7864</spage><epage>7870</epage><pages>7864-7870</pages><issn>0732-183X</issn><eissn>1527-7755</eissn><abstract>Infection is a serious complication of central venous catheters in immunocompromised patients. Catheter-related infection may be caused by fibrin deposition associated with catheters. Interventions designed to decrease fibrin deposition have the potential to reduce catheter-related infections. The purpose of this study was to evaluate the role of low-dose unfractionated heparin in preventing catheter-related bloodstream infection in patients with hemato-oncological disease.
This study was a randomized, controlled trial in which patients with nontunneled catheters were randomly assigned to receive either intravenous unfractionated heparin (continuous infusion of 100 U/kg per day) or 50 mL/day of normal saline solution as a continuous infusion (control group). Heparin was continued until the day of discharge. Catheter-related bloodstream infection was defined according to Infectious Disease Society of America guidelines.
Two hundred and eight patients were randomly assigned. Four patients were excluded after assignment. Ultimately, 204 patients were analyzed. Catheter-related bloodstream infection occurred in 6.8% (7 of 102 catheters) of those in the heparin group (2.5 events per 1,000 days) and in 16.6% (17 of 102 catheters) of those in the control group (6.4 events per 1,000 days) (P = .03). No other risk factors were found for the development of catheter-related bloodstream infection. Four and five patients experienced severe bleeding in the heparin and control groups, respectively (P = .2). We did not observe heparin-induced thrombocytopenia.
The use of continuous infusion of low-dose unfractionated heparin (100 U/kg per day) can be a practical and economical approach to the prevention of catheter-related bloodstream infection in patients with hemato-oncological disease.</abstract><cop>Baltimore, MD</cop><pub>American Society of Clinical Oncology</pub><pmid>16258088</pmid><doi>10.1200/JCO.2004.00.9787</doi><tpages>7</tpages></addata></record> |
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| source | MEDLINE; American Society of Clinical Oncology Online Journals; EZB-FREE-00999 freely available EZB journals |
| subjects | Adolescent Adult Anti-Infective Agents - economics Anti-Infective Agents - therapeutic use Biological and medical sciences Catheterization, Central Venous - adverse effects Catheters, Indwelling - adverse effects Catheters, Indwelling - microbiology Child Child, Preschool Female Hematologic Neoplasms - complications Hematologic Neoplasms - microbiology Hematologic Neoplasms - therapy Heparin, Low-Molecular-Weight - administration & dosage Humans Incidence Infusions, Intravenous Male Medical sciences Middle Aged Prospective Studies Risk Factors Sepsis - microbiology Sepsis - prevention & control Tumors |
| title | Randomized Trial of Prevention of Catheter-Related Bloodstream Infection by Continuous Infusion of Low-Dose Unfractionated Heparin in Patients With Hematologic and Oncologic Disease |
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