I included this in one of my AVA presentations. Use of warfarin as
prophylaxis is a controversial issue with studies being very small
and showing both a positive outcome and no benefit. If it is used,
even a low dose of 1-2 mg per day requires monitoring of PT and INR.
This can be the problem as these coag times can be very high even
with small doses. A set of practice guidelines on anticoagulants and
thrombolytics published in Chest from the Thoracic surgeons in 2004
did not support the routine use of low dose warfarin. But, in my
opinion, the did not have a true appreciation for the huge burden
from catheter-related thrombosis. They had very little data and their
statements almost sounded very cavalier about the issue. Lynn
At 8:10 AM -0600 9/14/06, Kokotis, Kathy wrote:
I think the jury is still deciding on this one
In fact at AVA one MD agreed with the usage for those who had
previous thrombosis and a high risk of thrombosis for cancer
patients and that was the Italian Physician who was setting up
country wide vascular access guidelines from the EVAN project.
Studies go both ways but a wise doctor said to be what does it hurt
with a low dose for someone who is high risk?
Kathy
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-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of
[EMAIL PROTECTED]
Sent: Wednesday, September 13, 2006 10:48 AM
To: [EMAIL PROTECTED]; [EMAIL PROTECTED]; [EMAIL PROTECTED]
Subject: Re: Portacath warfarin prophylaxis
See Cancer Control Journal of the Moffitt Cancer Center. Vol. 12,
September 2005., Supplement 1 "Venous Thromboembolism and
Cancer:Current Issues and Treatment Directions"
www.MoffittCancerCenter.org/ccjournal
page 34 question #7.
-----Original Message-----
From: [EMAIL PROTECTED]
To: [EMAIL PROTECTED]; [EMAIL PROTECTED]
Sent: Wed, 13 Sep 2006 9:30 AM
Subject: Re: FW: Portacath warfarin prophylaxis
This is a controversial issue. There are small studies in
oncology patients that support its use and some that do not. There
was a series of practice guidelines related to anticoagulants and
thrombolytics published in Chest 2004 and they recommended against
its use. My opinion of that piece was that they did not have a good
understanding of the true clinical impact of catheter-related
thrombosis. But that is the most recent thing I can recommend. Lynn
At 8:24 AM -0700 9/13/06, Marilyn Patterson wrote:
This question from an internal medicine doc. Has this
recommendation changed? Does any one have any references I can
forward to this MD?
Thanks as always so much for all your valued input and expertise.
Marilyn Patterson RN CRN, CRNI Port Angeles, WA --------
From: Mark Fischer
Sent: Tuesday, September 12, 2006 3:41 PM
To: Marilyn Patterson; Tami Spaeder
Subject: Portacath warfarin prophylaxis Hi Marilyn or Tami
Historically, pt's have taken warfarin 1mg/day for this.. Recently,
I think I've heard this is no longer recommended, right ? Do you
have a reference to support this ? Thanks mark
--
Lynn Hadaway, M.Ed., RNC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861
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Lynn Hadaway, M.Ed., RNC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861
