They only referenced one study on PICCs, did not look at data on
thrombosis from other central lines and their own wording stated that
this was not a big clinical issue. That is what I based my opinion on
that they did not have a true appreciation of the entire problem
faced by nurses and patients who deal with catheter occlusion. I
would invite you to read this report and make your own opinion about
their statements. Lynn
At 1:46 PM -0400 9/14/06, Marilyn Hanchett wrote:
I am curious: how exactly does a set of rigorously reviewed,
evidence-based guidelines from an international group of
physician-experts sound cavalier?
Please clarify - based on data, not opinion - why this analysis was
sufficently compelling and convincing to be published by this
organziation but you think they "did not have a true appreciation."
After all, we advocate evidence - not opinion - based practice, don't
we?
Marilyn Hanchett RN
IgG America
-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Lynn Hadaway
Sent: Thursday, September 14, 2006 10:36 AM
To: Kokotis, Kathy; [EMAIL PROTECTED]; [EMAIL PROTECTED];
[EMAIL PROTECTED]
Subject: RE: Portacath warfarin prophylaxis
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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attachments.[v1.0] -----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
--
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
