D-dimer from central and peripheral blood samples in asymptomatic central venous catheter-related thrombosis in patients with cancer

2018 ◽  
Vol 34 (1) ◽  
pp. 52-57 ◽  
Author(s):  
Homero Nañez-Terreros ◽  
Jose C Jaime-Perez ◽  
Linda E Muñoz-Espinoza ◽  
Carlos R Camara-Lemaroy ◽  
Gerardo E Ornelas-Cortinas ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Venous Blood ◽  
Venous Catheter ◽  
Central Venous ◽  
False Negatives ◽  
Altman Plot ◽  
Patients With Cancer ◽  
Peripheral Samples ◽  
Catheter Related Thrombosis ◽  
D Dimer

Objectives To evaluate the usefulness of a negative D-dimer in peripheral or central venous blood to screen for asymptomatic catheter-related thrombosis in cancer patients. Methods D-dimer was measured in blood from central venous catheter and peripheral venous samples in 48 patients with cancer. Asymptomatic catheter-related thrombosis was identified via Doppler ultrasound. Bland and Altman’s limits of agreement analysis was used to compare sample sites. Sensitivity and specificity of D-dimer was calculated. Results Overall, 33 of the central samples and 32 of the peripheral samples had D-dimer levels below the cutoff (≥0.3 mg/l). Mean central D-dimer was 0.31 ± 0.35 mg/l; peripheral 0.24 ± 0.22 mg/l (p = 0.5). Bland–Altman plot showed that the two sample sites were not equivalent. Catheter-related thrombosis was demonstrated in five patients, and there were three false negatives. Peripheral D-dimer had a negative predictive value of 90.9%. Conclusions A negative D-dimer may be useful for screening asymptomatic catheter-related thrombosis in patients with cancer, but the central and peripheral sample sites are not equivalent.

scholarly journals Early prophylaxis of central venous catheter-related thrombosis using 1% chlorhexidine gluconate and chlorhexidine-gel-impregnated dressings: a retrospective cohort study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Tomoko Yamashita ◽  
Ayako Takamori ◽  
Akira Nakagawachi ◽  
Yoshinori Tanigawa ◽  
Yohei Hamada ◽  
...  
Keyword(s):  
Cohort Study ◽  
Central Venous Catheter ◽  
Retrospective Cohort Study ◽  
Critically Ill Patients ◽  
Retrospective Cohort ◽  
Venous Catheter ◽  
Chlorhexidine Gluconate ◽  
Central Venous ◽  
Chlorhexidine Gel ◽  
Catheter Related Thrombosis

Abstract To determine the prophylactic effect of using combined 1% alcoholic chlorhexidine gluconate and chlorhexidine gel-impregnated dressings (CGCD) on catheter-related thrombosis (CRT) in critically ill patients. This retrospective cohort study was performed in an intensive care unit from November 2009 to August 2014. The CRT incidence diagnosed with ultrasound examination was compared between patients applying CGCD and combined 10% aqueous povidone-iodine and standard transparent dressings (PITD) after central venous catheter insertion into the internal jugular vein for ≥ 48 h. CRT was stratified into early (within 7 days) and late (days 8–14) thromboses. Multivariate analyses using logistic regression models clarified the relationships between early- and late-CRT risks and skin antiseptic and catheter site dressing combinations. CRT occurred in 74 of 134 patients (55%), including 52 with early CRT and 22 with late CRT. Patients receiving CGCD had a significantly lower incidence of early CRT than those receiving PITD (odds ratio = 0.18; 95% confidence interval = 0.07–0.45, p  < .001). No significant association was evident between using CGCD and late CRT (p  = .514). Compared to PITD, CGCD reduced the CRT risk over 7 days in critically ill patients. UMIN Clinical Trials Registry: UMIN000037492.

scholarly journals A new technique for measuring fistula flow using venous blood gas oxygen saturation in patients with a central venous catheter

2019 ◽  
Vol 13 (2) ◽  
pp. 184-187
Author(s):  
Silverio Rotondi ◽  
Lida Tartaglione ◽  
Maria Luisa Muci ◽  
Marzia Pasquali ◽  
Nicola Pirozzi ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Oxygen Saturation ◽  
Venous Blood ◽  
Venous Catheter ◽  
Gas Analysis ◽  
Surgical Revision ◽  
Blood Gas ◽  
Manual Compression ◽  
Central Venous ◽  
Before And After

Abstract Background Doppler ultrasound (DU) monitoring early after arteriovenous fistula (AVF) creation allows the identification of low blood flow (Qa) requiring prompt revision, but it is costly (needs skilled operators and technical instruments) and is not available in all dialysis units. Therefore alternative first-line methods to measure Qa would be welcomed. We reasoned that once an AVF is created, an increment in central venous oxygen saturation (ScvO2) is predictable and proportional to Qa. Methods Accordingly, in patients receiving dialysis through a central venous catheter (CVC) in whom an AVF was created, we measured, by means of blood gas analysis, the ScvO2 increment before and after manual compression of the arteriovenous shunt and verified its correlation with DU-measured Qa. Results We sampled blood gas in 18 patients with CVC and AVF before and after 30 s manual compression of the AVF. ScvO2 averaged 70.5 ± 3% before and 65.2 ± 3% after AVF closure, with an average drop of 5.1 ± 3% (range 1–12). AVF Qa, which was measured within 24 h by means of DU, averaged 635 ± 349 mL/min (range 50–1300) and was strictly and positively correlated with ΔScvO2 (r = 0.954, P &lt; 0.0001). Conclusions Therefore we suggest that in patients with CVC and a newly created AVF, it is possible to monitor AVF Qa without DU by simply measuring blood gas and ΔScvO2. This technique is simple, cheap, repeatable, non-invasive and operator independent and represents a new useful screening test to detect delayed AVF access maturation deserving prompt DU measurement and surgical revision. It helps to quickly identify patients in urgent need of DU verification and possible surgical revision. Regrettably, it is applicable only in patients with CVC.

scholarly journals Downhill Esophageal Varices Associated With Central Venous Catheter-Related Thrombosis Managed With Endoscopic and Surgical Therapy

2016 ◽  
Vol 3 (1) ◽  
pp. e102 ◽  
Author(s):  
Joshua C. Berkowitz ◽  
Sushma Bhusal ◽  
Deepak Desai ◽  
Maurice A. Cerulli ◽  
Sumant Inamdar
Keyword(s):  
Central Venous Catheter ◽  
Surgical Therapy ◽  
Esophageal Varices ◽  
Venous Catheter ◽  
Central Venous ◽  
Catheter Related Thrombosis
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