Prevention of Catheter-Related Bloodstream Infection in Patients With Haemato-Oncological Disease

We, the researchers at Centre National de Greffe de Moelle Osseuse, have shown in a randomised study (in press), that a low dose of unfractionated heparin (100 IU/kg/daily) was safe and effective to prevent catheter-related bloodstream infection in patients with haemato-oncological disease. The aim of this prospective randomised controlled trial is to compare the incidence of catheter-related bloodstream infection in 2 groups of patients with haemato-oncological disease: Group A: heparin impregnated catheters Group B: low-dose unfractionated heparin (100 IU/kg/daily)

Studies have shown that catheter-related infection may be due to fibrin deposition associated with catheters. Interventions designed to decrease fibrin deposition and thrombus formation have the potential to reduce catheter-related infections. Seven randomised studies have been performed to assess the safety and efficacy of heparin (either as an infusion or bonded to central venous catheter) on central venous catheter-related bloodstream infections. Although a meta-analysis of 4 studies looking at heparin either as an infusion or bonded to central venous catheter showed a strong trend for a reduction in catheter-related bloodstream infection with the use of heparin, these studies used variable definitions of catheter-related infections. We have shown in a randomised study (in press), that low dose of unfractionated heparin (100 IU/kg/daily) was safe and effective to prevent catheter-related bloodstream infection in patients with haemato-oncological disease. The aim of this prospective randomised controlled trial is to compare the incidence of catheter-related bloodstream infection in 2 groups of patients with haemato-oncological disease: Group A: heparin impregnated catheters Group B: low-dose unfractionated heparin (100 IU/kg/daily)

Incidence of catheter-related bloodstream infection in 2 groups of patients with haemato-oncological disease

Group B: continuous infusion of low dose unfractionated heparin (100IU/kg/d) through non-impregnated catheter.

Analysis of variables that may be significant for the development of catheter-related bloodstream infection (catheter-related thrombosis; age; underlying disease; side of venous puncture; duration of catheterization)

Inclusion Criteria: Age between 4 and 60 years Short term non-tunneled percutaneous central venous catheter Exclusion Criteria: Presence of a central venous catheter at admission Major blood coagulation disorders (platelet count < 50 x 10^9, disseminated intravascular coagulation) Absence of catheter-tip culture at the time of catheter removal