To my knowledge there is
one study which describes the advantages of the use of Urokinase on a regular
basis in an attempt to prevent infection. Lieve
Weekly prophylactic urokinase instillation in tunneled
central venous access devices.
Ray CE Jr, Shenoy SS, McCarthy PL, Broderick KA, Kaufman JA.
Department of Interventional Radiology, Roswell Park Cancer Institute, Buffalo,
NY, USA.
PURPOSE: To determine the safety and efficacy of weekly prophylactic urokinase
therapy in tunneled central venous access devices (VADs). MATERIALS AND
METHODS: A prospective, randomized study was performed in 105 patients who
underwent tunneled VAD placement between March 1997 and April 1998. The
patients were randomized to receive either twice-daily heparin flushes (14
heparin flushes per week; group A, n = 52) or twice-daily heparin flushes with
once-weekly urokinase (UK) instillation (13 heparin flushes, one UK flush per
week; group B, n = 53). Patients were followed up by examination and/or
interview at 1, 3, and 6 months for signs and symptoms of delayed
catheter-related complications. RESULTS: The total number of indwelling
catheter-days was similar between groups (5,450 in group A, 5,276 in group B). The
total number of infectious complications and fibrin sheaths formed was greater
for group A (n = 11; 21.1%) than group B (n = 3; 5.7%) (P = .02). There were no
side effects noted from the prophylactic UK administrations. CONCLUSION:
Prophylactic UK is advantageous in preventing delayed catheter-related
complications.
Van:
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Verzonden: woensdag 30 november
2005 4:01
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Onderwerp: Re: question for group
new subject
Donna:
This makes a lot of sense. Do you have any studies regarding this? Would
you be interested in doing one?
-----Original Message-----
From: Donna J Gordon DJGORDON <[EMAIL PROTECTED]>
To: Lynn Hadaway <[EMAIL PROTECTED]>
Cc: Innes, Kim Bourn <[EMAIL PROTECTED]>; Nicastro, Margaret
<[EMAIL PROTECTED]>; Stone, Gloria <[EMAIL PROTECTED]>; Nancy
Costa <[EMAIL PROTECTED]>; [EMAIL PROTECTED];
[EMAIL PROTECTED]; Kimberly Sutters <[EMAIL PROTECTED]>
Sent: Tue, 29 Nov 2005 20:06:37 -0500
Subject: RE: question for group new subject
We have used altepase for catheter infections, especially
on peds patients. If a lot of blood is being drawn through the line, there is
the risk of fibrin buildup within the catheter lumen, regardless of how
carefully you flush. Using the altepase to "clean out" the lumen
eliminates the breeding ground for the bacteria...works well
