PEDIATRICS Vol. 83 No. 6 June 1989, pp. 963-966
This Article
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Bagnall, H. A.
Right arrow Articles by Atkinson, J. B.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Bagnall, H. A.
Right arrow Articles by Atkinson, J. B.

Continuous Infusion of Low-Dose Urokinase in the Treatment of Central Venous Catheter Thrombosis in Infants and Children

Holly A. Bagnall RN, MN1, Edward Gomperts MD1, and James B. Atkinson MD1

1 The Division of Pediatric Surgery and the Division of Hematology/Oncology, Children`s Hospital of Los Angeles and the University of Southern California School of Medicine, Los Angeles

Thrombotic occlusion is a frequent complication associated with the use of central venous catheters. The purpose of this study was to evaluate the efficacy of a continuous infusion of low-dose urokinase (200 U/kg/h) in clearing catheters that had not cleared after two bolus doses of urokinase in a pediatric oncology population. Fifty-eight incidents of catheter-related occlusions (49 Hickman-type catheters/nine implantable ports) as documented by radiographic dye study occurred in 227 pediatric oncology patients with 254 central venous catheters during a 1-year period. Fourteen of 58 catheters failed to clear after two bolus instillations of urokinase (5,000 U and 10,000 U). Thirteen catheters were treated for 24 hours with urokinase, 200 U/kg/h, and one catheter with urokinase, 100 U/kg/h for 24 hours. Twelve catheters were used for study. Coagulation studies were monitored preinfusion, 12 hours into the infusion, and postinfusion. Patency was reestablished in 11/12 catheters (92%) with a mean infusion time of 28.7 hours. No coagulation abnormalities or clinical bleeding associated with the urokinase infusion occurred. Only one patient exhibited a prolonged partial thromboplastin time (> 150 seconds); this was associated with a heparin effect. These data indicate that low-dose urokinase may be a safe and effective means to clear occluded central venous catheters in children.

Key Words: low-dose urokinase • central venous catheter • thrombotic occlusion

Submitted on May 2, 1988
Accepted on July 11, 1988




This article has been cited by other articles:


Home page
 Br J AnaesthHome page
S. Galloway and A. Bodenham
Long-term central venous access
Br. J. Anaesth., May 1, 2004; 92(5): 722 - 734.
[Abstract] [Full Text] [PDF]

Home page
 Nutr Clin PractHome page
E. G. Ford
Invited Review: Nutrition Support of Pediatric Patients
Nutr Clin Pract, October 1, 1996; 11(5): 183 - 191.
[Abstract] [PDF]

Home page
 Nutr Clin PractHome page
M. Evans and M. A. Ryder
Invited Review: Vascular Access Devices: Perspectives on Designs, Complications, and Management
Nutr Clin Pract, August 1, 1993; 8(4): 145 - 152.
[Abstract] [PDF]

Home page
 Journal of Pediatric Oncology NursingHome page
H. Bagnall-Reeb and K. Ruccione
Practical Application of an Algorithm for the Thrombolytic Treatment of Occluded Vascular Access Devices
Journal of Pediatric Oncology Nursing, January 1, 1993; 10(2): 79 - 82.
[PDF]

Home page
 Journal of Pediatric Oncology NursingHome page
D. Keegan-Wells and J. L. Stewart
The Use of Venous Access Devices in Pediatric Oncology Nursing Practice
Journal of Pediatric Oncology Nursing, January 1, 1992; 9(4): 159 - 169.
[Abstract] [PDF]

Home page
 JWatch GeneralHome page
UROKINASE TO UNCLOG CATHETERS IN CHILDREN
Journal Watch (General), June 20, 1989; 1989(620): 7 - 7.
[Full Text]