Document Detail

The relationship between the thrombotic and infectious complications of central venous catheters.
MedLine Citation:
PMID:  8139059     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To assess the frequency of thrombotic and infectious complications of long-term use of vascular catheters in cancer patients and to determine whether the two types of complication are related.
DESIGN: Case series.
SETTING: A 500-bed tertiary cancer center.
PATIENTS: Seventy-two cancer patients.
INTERVENTIONS: During a 16-month period, postmortem examinations of catheterized veins and contralateral uncatheterized veins were done on all patients with indwelling central venous catheters who met study criteria.
MAIN OUTCOME MEASURES: Catheter-related septicemia determined by clinical and microbiological data as well as postmortem pathology; venous pathological changes such as mural hemorrhage, thrombosis, calcification, ulceration, and inflammation.
RESULTS: Premortem clinical and microbiological data were obtained retrospectively on all patients. Pathological changes were noted in 35 catheterized veins (49%) compared with five contralateral control veins (9.2%) (P < .001). Mural thrombi were noted in 27 catheterized veins (38%) compared with only one contralateral control vein (1.4%) (P < .001). Other pathological changes consisted of four central venous catheter-related mural thrombi (5.6%) in the right atrium and four instances (5.6%) of nonbacterial thrombotic endocarditis, three involving the tricuspid and one the mitral valves. Seven patients had catheter-related septicemia. Of the 31 patients with mural thrombosis of the catheterized vein or right atrium, seven developed catheter-related septicemia, whereas none of the 41 patients with normal catheterized veins and atria developed catheter-related septicemia (P < .01).
CONCLUSIONS: Thrombotic complications are common in catheterized veins and are often associated with catheter sepsis.
I I Raad; M Luna; S A Khalil; J W Costerton; C Lam; G P Bodey
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  JAMA     Volume:  271     ISSN:  0098-7484     ISO Abbreviation:  JAMA     Publication Date:  1994 Apr 
Date Detail:
Created Date:  1994-04-25     Completed Date:  1994-04-25     Revised Date:  2014-09-17    
Medline Journal Info:
Nlm Unique ID:  7501160     Medline TA:  JAMA     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1014-6     Citation Subset:  AIM; IM    
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MeSH Terms
Aged, 80 and over
Catheterization, Central Venous / adverse effects*
Catheters, Indwelling / adverse effects*
Heart Diseases / etiology*,  microbiology,  pathology
Middle Aged
Neoplasms / therapy
Sepsis / etiology*
Thrombosis / etiology*,  microbiology,  pathology
Vascular Diseases / etiology,  pathology
Veins / microbiology,  pathology*

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