scholarly journals The effect of different concentrations of heparin sealing liquid on thrombosis after peripherally inserted Central Catheter catheterization in tumor patients (HEALTH): protocol for a prospective, single-blind, randomized, controlled trial

2018 ◽  
Author(s):  
Zhimin Wang ◽  
Peiyi He ◽  
Jianning Wei ◽  
Ping Du
Keyword(s):  
Venous Thrombosis ◽  
Upper Extremity ◽  
Controlled Trial ◽  
Physiological Saline ◽  
Central Catheter ◽  
Tumor Patients ◽  
Vein Thrombosis ◽  
Randomized Controlled ◽  
Deep Vein ◽  
Single Blind

Abstract Background: Malignant tumor patients with peripherally inserted central catheter (PICC) are at high risk of developing deep venous thrombosis. Different concentrations of sealing liquid result in different outcomes. However, there is a lack of evidence of large randomized controlled trials to show the different incidences of deep vein thrombosis using different concentrations of sealing liquid. The aim of this study is to compare the difference in the incidence of deep vein thrombosis of the upper extremity in cancer patients with PICC using physiological saline, 10 U/ml heparin, and 50 U/ml heparin, separately. Methods: A three-arm, single-center, single-blind, randomized controlled trial will be performed. We plan to recruit a total of 639 cancer patients within 12 months with a follow-up period of six months. Patients will be randomized at 1:1:1 ratio by centralized service allocation concealment. Sealing liquid with different concentrations, i.e. physiological saline, 10 U/ml heparin, and 50 U/ml heparin will be administered. Primary outcome is the incidence of upper extremity venous thrombosis. Secondary outcomes include the time of thrombus and the severity of thrombosis with three grades. All randomized patients will be analyzed by intention-to-treat. Chi-square test will be used to compare the incidence of upper extremity venous thrombosis. Kaplan-Meier survival curve and log-rank test will be presented to compare thrombus in relation to time. A Cox regression will test the effect of group on thrombus, with hazard ratio adjusted for significant clinical variables. Discussion: The trial will help to resolve the uncertainty of the clinical practice of PICC catheterization liquid concentration, and to provide the basis for the implementing the clinical intervention and effectively reducing PICC-related venous thrombosis. The present study is ongoing, and data will be published in peer-reviewed journals after its conclusion. Trial registration: Chinese Clinical Trial Registry, ChiCTR1800018391. Registered on 14 September 2018 - Retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=30808.

scholarly journals Upper extremity deep venous thrombosis secondary to thyrotoxic periodic paralysis with accompanying hyperphosphatemia and severe hypomagnesemia

2021 ◽  
Vol 9 (41) ◽  
pp. 47-49
Author(s):  
Jasmin Rahesh ◽  
Layan Al-Sukhni ◽  
Baseer Quraishi ◽  
Tarek Naguib
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Upper Extremity ◽  
Periodic Paralysis ◽  
Central Catheter ◽  
Thyrotoxic Periodic Paralysis ◽  
Vein Thrombosis ◽  
Life Threatening ◽  
Characteristic Features ◽  
Deep Vein

Thyrotoxic periodic paralysis is a rare but life-threatening complication of hyperthyroidism. Characteristic features involve thyrotoxicosis, acute paralysis, and hypokalemia. Mild hypomagnesemia and hypophosphatemia are also present in most cases due to the resulting transcellular shift of electrolytes. Complications of thyrotoxic periodic paralysis reported in the literature have included cerebral venous thrombosis as well as lower extremity deep venous thrombosis. We present a patient with an unusual presentation of thyrotoxic periodic paralysis as reflected by hyperphosphatemia, upper extremity deep venous thrombosis and severe hypomagnesemia. This is the first reported case of upper extremity deep vein thrombosis in association with a peripherally inserted central catheter line secondary to thyrotoxicosis.

scholarly journals Risk of Deep Vein Thrombosis After Acute Achilles Tendon Rupture: A Secondary Analysis of a Randomized Controlled Trial Comparing Early Controlled Motion of the Ankle Versus Immobilization

2020 ◽  
Vol 8 (4) ◽  
pp. 232596712091590 ◽  
Author(s):  
Kristoffer Weisskirchner Barfod ◽  
Emil Graakjær Nielsen ◽  
Beth Hærsted Olsen ◽  
Pablo Gustavo Vinicoff ◽  
Anders Troelsen ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Controlled Trial ◽  
Achilles Tendon Rupture ◽  
Vein Thrombosis ◽  
Randomized Controlled ◽  
Deep Vein ◽  
D Dimer

Background: Immobilization of the ankle joint has been suggested as a key element in the pathogenesis leading to deep vein thrombosis (DVT). Purpose: To investigate whether early controlled ankle motion (ECM) could reduce the incidence of DVT compared with immobilization (IM) in the treatment of acute Achilles tendon rupture. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: Patients aged 18 to 70 years were eligible for inclusion, and treatment was nonoperative. The ECM group performed movements of the ankle 5 times a day from weeks 3 to 8 after rupture. The control group was immobilized for 8 weeks. The outcome measure was DVT diagnosed with color Doppler ultrasound for above- and below-knee DVT at 2 and 8 weeks. The Achilles tendon Total Rupture Score, the heel-rise work test, and the Copenhagen Achilles ultrasonographic Length Measurement were performed at 4-, 6-, and 12-month follow-up. Results: A total of 189 patients were assessed for eligibility from February 2014 to December 2016. Of these, 130 were randomized: 68 patients were allocated to the ECM group and 62 to the IM group. All patients participated in follow-up at 8 weeks assessing for DVT. In total, 62 (47.7%) patients were diagnosed with DVT: 33 of 68 (48.5%) in the ECM group and 28 of 61 (46.8%) in the IM group ( P = .84). DVT did not affect treatment outcomes at 4, 6, and 12 months. D-dimer had low sensitivity (71%) for detecting DVT. Conclusion: We found that 1 in 2 patients presented with DVT in nonoperative treatment of acute Achilles tendon rupture. The ECM protocol revealed no benefit versus IM in reducing the incidence of DVT. DVT did not influence functional and patient-reported outcomes the first year after rupture. D-dimer seems an inappropriate test for detection of DVT in patients with acute Achilles tendon rupture. Registration: NCT02015364 ( ClinicalTrials.gov identifier).

Sign in / Sign up

Export Citation Format

Share Document