No effect of nadroparin prophylaxis in the prevention of central venous catheter (CVC)-associated thrombosis in bone marrow transplant recipients

Abstract

Summary:Complications of CVCs in 382 consecutive patients receiving a stem cell transplantation (SCT) were analysed. Early complications were pneumothorax (3.6%), haematothorax (0.5%), dislocation (3%) and dysfunction (3.6%). Eighty-seven-associated infections (22%) were observed, leading to removal of the CVC in 26 patients. More bacteraemias were associated with double-or triple-lumen CVCs, 19% vs 5% in single lumen CVCs (P Ͻ 0.0001). Coagulase-negative staphylococci were the predominant microorganisms in 72%. A special point of investigation was CVC-associated thrombosis and the prophylactic value of nadroparin. Two consecutive regimens with nadroparin were used and compared; 7 days 2850 IE nadroparin and 10 days 5700 IE nadroparin. The incidence of CVC-associated thrombosis was 6.9% in 382 patients with 390 catheters. The incidence was 8% in patients receiving one of the prophylactic nadroparin regimens compared to 6% in a comparable control group without prophylaxis. A short course of nadroparin was unable to prevent thrombotic complications after discontinuation. Bone Marrow Transplantation (2000) 26, 1103-1106.

Catheter tip position as a risk factor for thrombosis associated with the use of subcutaneous infusion ports

“…Recently, Mismetti et al have shown that LMWH and low doses of warfarin are as efficient in the prevention of CRT [20]. However, shorter courses of LMHW (7 to 10 days or 30 days) have not been proven to be effective in preventing CRT [16,19].…”

Prophylaxis of central venous catheter‐related thrombosis with minidose warfarin in patients treated with high‐dose chemotherapy and peripheral‐blood stem‐cell transplantation: Retrospective analysis of 228 cancer patients

“…In a retrospective study, Lagro et al found nadroparin to be ineffective in the prevention of CVCrelated thrombosis in bone-marrow transplant recipients [17]. The occurrence of thrombosis was 17 out of 221 (8%) in patients taking prophylaxis compared to 10 out of 161 (6%) patients receiving no prophylaxis.…”

Prophylaxis of port system-associated thromboses in advanced oncology patients using heparin flushing

“…All catheters were flushed with 7 ml UFH (100 IU/ml) daily as well as after blood was drawn or drugs/blood products were administered. The thromboses were observed only after 22 days (median) and between day 5 and day 92, respectively (Lagro et al 2000). Attention should thus be paid to the longer-term assurance of effective prophylaxis of port catheter-associated thromboses.…”