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Thromboprophylaxis of central venous lines in children with cancer: The first steps taken on the long road ahead
Author(s) -
Massicotte Patricia,
Mitchell Lesley
Publication year - 2006
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1080/08035250600746328
Subject(s) - medicine , warfarin , pulmonary embolism , thrombosis , randomized controlled trial , venous thrombosis , malignancy , catheter , anticoagulant , surgery , central venous catheter , cancer , intensive care medicine , atrial fibrillation
Approximately one third of children with malignancy and central venous lines develop catheter‐related thrombosis, with the reported sequelae including death, pulmonary embolism, chylothoraces, superior vena cava syndrome and post‐thrombotic syndrome. These complications prompt the design and completion of randomized, controlled trials to determine a safe and efficacious therapy to prevent these thromboses. The authors Ruud et al. have presented a well‐designed, randomized, controlled trial which demonstrates the lack of utility of using low‐dose warfarin to prevent catheter‐related thrombosis in children with central lines and acute lymphoblastic leukaemia. The difficulties with warfarin in children are again demonstrated in this study. Conclusion: Further studies are warranted using other thromboprophylactic agents with less or no monitoring and fewer drug interactions, including the newer anticoagulant agents such as direct thrombin inhibitors.