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    Prospective Audit to Study urokinaSe use to restore Patency in Occluded centRal venous caTheters in haematology and oncology patients (PASSPORT 2)

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    Authors
    Kumwenda, M. J.
    Dougherty, L.
    Jackson, A.
    Hill, Steve
    Affiliation
    Renal & Diabetes Center, Glan Clwyd Hospital, Rhyl, UK.
    Issue Date
    2020
    
    Metadata
    Show full item record
    Abstract
    Background: Central venous catheter dysfunction may be associated with intraluminal clots, drug precipitates and lipid residues or extra luminal causes such as fibroblastic sleeve, tip malposition, pinch-off syndrome and venous thrombosis at the tip of central venous catheter. Failure to restore patency after addressing these causes, empirical treatment with thrombolytic agents should be considered. Urokinase is used widely as a thrombolytic agent but very few outcome studies have been published. Methods: A multicentre group conducted a prospective audit of management of central venous catheter dysfunction after exclusion of common causes using in centre standardised doses of urokinase from September 2017 to February 2018 in haematology and oncology units. Data of catheter blood flow were collected anonymously following administration of 5000to 25,000-IU urokinase in dysfunctional central venous catheter. Results: A total of 117 patients were recruited from eight centres, 54 females and 63 males, median age was 60 (46-68). In total, 53% presented as partial withdrawal occlusion and 47% total occlusion. In partial withdrawal occlusion, patency was restored in 80% of interventions, in 82% of interventions using push lock and in 76% using dwell lock. In total occlusion, patency was restored in 88% of the interventions. The central venous catheter clearance rate was dose dependent; patency was restored in 83% of central venous catheter with 5000 IU, 89% with 10,000 IU and 92% with high dose of 25,000 IU. No adverse events were recorded. Conclusion: In this study, treatment of dysfunctional central venous catheter using standardised urokinase doses was safe and effective in restoring patency when no other mechanical causes could account for central venous catheter dysfunction.
    Citation
    Kumwenda MJ, Dougherty L, Jackson A, Hill S. Prospective Audit to Study urokinaSe use to restore Patency in Occluded centRal venous caTheters in haematology and oncology patients (PASSPORT 2). The journal of vascular access. 2020:1129729820950997.
    Journal
    Journal of Vascular Access
    URI
    http://hdl.handle.net/10541/623287
    DOI
    10.1177/1129729820950997
    PubMed ID
    32867568
    Additional Links
    https://dx.doi.org/10.1177/1129729820950997
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1177/1129729820950997
    Scopus Count
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