Use of heparin versus lepirudin flushes to prevent withdrawal occlusion of central venous access devices

McDonald K. Horne, Donna Jo McCloskey, Karim Calis, Robert Wesley, Richard Childs, Claude Sportes

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Study Objective. To determine whether lepirudin flushes are more effective than heparinized saline in preventing withdrawal occlusion of central venous access devices. Design. Randomized, double-blind clinical trial. Setting. Research institution-tertiary referral center. Patients. Forty-nine adults undergoing bone marrow transplantation for hematologic malignancies or metastatic solid tumors. Intervention. Twenty-four patients received heparin and 25 received lepirudin flushes. The heparin dose was 3 ml of porcine heparin 100 U/ml (300 U) per catheter lumen at least once/day; the lepirudin dose was 3 ml of lepirudin 100 pg/ml (300 pg) per catheter lumen at least once/day. After 3-4 weeks, all 49 patients received the heparin flushes. Measurements and Main Results. Efficacy was assessed by the frequency with which the patients were treated with alteplase instillations for withdrawal occlusion of their central venous access devices during the first 4 months of catheterization. Three (12.5%) patients treated with heparin alone and five (20%) treated initially with lepirudin required alteplase instillations for an estimated relative risk with lepirudin versus heparin of 1.6 (95% confidence interval [CI] 0.40-13.86, p=0.70). Conclusion. Lepirudin was not more effective than heparin, which may have been related to the conservative dose of lepirudin administered. However, higher lepirudin doses are likely to incur an unacceptable risk of systemic anticoagulation.

Original languageEnglish (US)
Pages (from-to)1262-1267
Number of pages6
JournalPharmacotherapy
Volume26
Issue number9 I
DOIs
StatePublished - Sep 1 2006

Fingerprint

Heparin
Equipment and Supplies
Tissue Plasminogen Activator
Catheters
lepirudin
Hematologic Neoplasms
Bone Marrow Transplantation
Tertiary Care Centers
Catheterization
Swine
Clinical Trials
Confidence Intervals
Research
Neoplasms

Keywords

  • Catheter function
  • Heparin
  • Lepirudin
  • Venous access device
  • Withdrawal occlusion

ASJC Scopus subject areas

  • Pharmacology (medical)

Cite this

Horne, M. K., McCloskey, D. J., Calis, K., Wesley, R., Childs, R., & Sportes, C. (2006). Use of heparin versus lepirudin flushes to prevent withdrawal occlusion of central venous access devices. Pharmacotherapy, 26(9 I), 1262-1267. https://doi.org/10.1592/phco.26.9.1262

Use of heparin versus lepirudin flushes to prevent withdrawal occlusion of central venous access devices. / Horne, McDonald K.; McCloskey, Donna Jo; Calis, Karim; Wesley, Robert; Childs, Richard; Sportes, Claude.

In: Pharmacotherapy, Vol. 26, No. 9 I, 01.09.2006, p. 1262-1267.

Research output: Contribution to journalArticle

Horne, MK, McCloskey, DJ, Calis, K, Wesley, R, Childs, R & Sportes, C 2006, 'Use of heparin versus lepirudin flushes to prevent withdrawal occlusion of central venous access devices', Pharmacotherapy, vol. 26, no. 9 I, pp. 1262-1267. https://doi.org/10.1592/phco.26.9.1262
Horne, McDonald K. ; McCloskey, Donna Jo ; Calis, Karim ; Wesley, Robert ; Childs, Richard ; Sportes, Claude. / Use of heparin versus lepirudin flushes to prevent withdrawal occlusion of central venous access devices. In: Pharmacotherapy. 2006 ; Vol. 26, No. 9 I. pp. 1262-1267.
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