Should paediatric central lines be aspirated before use?

Coulthard, Malcolm G.; Skinner, Roderick
June 2007
Archives of Disease in Childhood;Jun2007, Vol. 92 Issue 6, p517
Academic Journal
As blood clots commonly occur in the lumens of paediatric haemodialysis central-venous lines, they must be routinely aspirated before use to prevent pulmonary emboli. The smaller diameter lines used for parenteral nutrition and cancer chemotherapy are seldom managed this way. We looked for clots formed when children undergoing cancer chemotherapy had their heparin-locked central lines accessed, and compared with the lines of children undergoing haemodialysis. Patients undergoing haemodialysis had clots aspirated on 83% of occasions, and each child had clots at least once. Clots also occurred in the smaller lines, but they were less frequent (64%, p=0.01), and had a lower median weight than those in dialysis lines (14.1 v 25.2 mg, p=0.01). When small diameter central lines are used without initial aspiration, small pulmonary emboli are likely to occur, but are unlikely to be individually clinically important. Daily use, as with long-term parenteral nutrition, might result in >3 g of clot being embolised annually. Consideration should be given to aspirating all paediatric central lines before use.


Related Articles

  • Aspiration Thrombectomy in a Patient with Suprarenal Inferior Vena Cava Thrombosis. Kishima, Hideyuki; Fukunaga, Masashi; Nishian, Kunihiko; Saita, Ten; Horimatsu, Tetsuo; Sugahara, Masataka; Mine, Takanao; Masuyama, Tohru // Case Reports in Cardiology;1/27/2015, Vol. 2015, p1 

    DVT has rarely been observed in the inferior vena cava (IVC). Pulmonary embolism (PE), which can be life-threatening, often occurred in patients with IVC thrombosis. Therefore, an IVC filter is frequently used in those patients for the prevention of PE. A case of successful endovascular...

  • Management of deep vein thrombosis to reduce the incidence of post-thrombotic syndrome. Lowe, G. D. O. // Phlebology;Oct2010 Supplement 1, Vol. 25, p9 

    The post-thrombotic syndrome (PTS) is the major chronic sequel of deep vein thrombosis (DVT) of the leg, and is a major socioeconomic challenge. In addition to systematic prophylaxis of DVT in hospitalized patients, effective management of DVT is important to reduce the incidence of PTS....

  • Comparison of alteplase and heparin in maintaining the patency of paediatric central venous haemodialysis lines: a randomised controlled trial. Giffins, Nicola S.; Hunter-Blair, Yan L.; Matthews, John N. S.; Coulthard, Malcolm G. // Archives of Disease in Childhood;Jun2007, Vol. 92 Issue 6, p499 

    Objectives: To determine whether the tissue plasminogen activator, alteplase, is more effective than heparin in preventing blood clots developing in children's haemodialysis central lines between dialysis sessions. Design: A prospective double-blind, within-patient multiperiod cross-over...

  • HEPARINS (LOW MOLECULAR WEIGHT)/HEPARINOIDS.  // Davis's Drug Guide for Nurses, 10th edition;2007, p589 

    The article presents a nursing guide for several heparinoids, drugs used for prevention of deep vein thrombosis and pulmonary embolism after abdominal surgery, knee/hip surgery or replacement. The mechanism of action of the anticoagulants are discussed. Information on their pharmacokinetics is...

  • Curtailing blood clots. Sherman, Carl // Cortlandt Forum;May2007, Vol. 20 Issue 5, p72 

    The article discusses the immediate treatment for deep venous thrombosis (DVT) to avoid pulmonary embolism (PE) and other complications. The author recommends the Wells Prediction Rule as early diagnosis of venous thromboembolism (VTE), but the wells score are more significant for those younger...

  • Challenging pulmonary embolism - A new generation of oral anticoagulants. Barra, Sérgio; Paiva, Luís; Providência, Rui // Journal of Thoracic Disease;Jun2012, Vol. 4 Issue 3, p244 

    The article highlights the need for early and accurate diagnosis of acute pulmonary embolism (PE). It discusses the role of anticoagulant treatment in management of patients with PE. Studies showing promising results for the use of oral anticoagulants such as dabigatran, a selective thrombin...

  • Activated clotting time tube malfunction: A rare cause of heparin overdose. Kumar, Bhupesh; Badamali, Ashok Kumar // Annals of Cardiac Anaesthesia;Apr-Jun2013, Vol. 16 Issue 2, p155 

    A letter to the editor is presented about a case of heparin overdose caused by activated clotting time (ACT) tube malfunction in a 2-year old male child.

  • Aspiration system reopened blocked vessels after acute ischemic stroke. Raible, Eric; Vetrovec, George W. // Cardiology Today;Apr2008, Vol. 11 Issue 4, p26 

    The article reports that the Penumbra system is effective in improving recanalization rates and TIMI scores in patients with large vessel occlusions. The aspiration device utilizes the suction applied with the tip of an aspiration catheter and inserts a grasping mechanism into the blockage if...

  • Derivation of the non-inferiority margin for the evaluation of direct oral anticoagulants in the treatment of venous thromboembolism. Prins, Martin H.; Lensing, Anthonie W. A. // Thrombosis Journal;2013, Vol. 11 Issue 1, p13 

    Background: Direct oral anticoagulants that target a single coagulation factor have been developed as an alternative to standard therapies with heparin and/or vitamin K antagonists. The purpose of this study was to derive non-inferiority margins suitable for randomised clinical studies designed...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics