Prophylactic urokinase in the management of long-term venous access devices in children: a Children's Oncology Group study

Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
Peter W DillonChildren's Oncology Group

Abstract

Infection and thrombosis are serious complications of long-term vascular access devices in children undergoing chemotherapy. Since routine fibrinolytic therapy may decrease these complications, the purpose of this study was to compare the efficacy of an every-2-week administration of urokinase with standard heparin flushes in reducing the incidence of device-related infections and occlusions. This study was a prospective, randomized phase III multicenter trial conducted by the Children's Cancer Group, in which patients with implantable ports or tunneled catheters received either urokinase or heparin every 2 weeks for 12 months. Study end points were time to first occlusion or time to first device-related infection. Five hundred seventy-seven patients from 29 institutions were enrolled, of whom 51% had external catheters and 49% had ports. Urokinase administration resulted in fewer occlusive events than heparin (23% v 31%; P =.02), a longer time to first occlusive event (log-rank analysis, P =.006), and a 1.6-fold difference in the rate of occlusive events (Poisson regression, P =.003). Similar results were noted when comparing ports and tunneled catheters. The urokinase group also had a 1.4-fold difference in the rate of infect...Continue Reading

References

Feb 1, 1989·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·J MirroM Hancock
Mar 1, 1996·JPEN. Journal of Parenteral and Enteral Nutrition·L O'FarrellC M Lang
Dec 10, 1999·Journal of Vascular and Interventional Radiology : JVIR·C E RayJ A Kaufman
Sep 29, 2001·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·R O Darouiche
Nov 27, 2001·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·B SolomonH M Prince
Apr 9, 2002·Pediatric Hematology and Oncology·Maria KalmantiGeorge Charisis
Apr 10, 2002·Critical Care Medicine·John R MehallSamuel D Smith

❮ Previous
Next ❯

Citations

Jan 27, 2010·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Alan R SchroederStephen J Roth
Feb 9, 2013·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Courtney M RowanMara E Nitu
Mar 22, 2006·Acta Haematologica·Shoshana Revel-Vilk
Sep 18, 2013·Critical Care : the Official Journal of the Critical Care Forum·Susanne JanumArash Afshari
Dec 20, 2011·Haematologica·Jacquelyn L BaskinScott C Howard
Aug 6, 2013·Indian Journal of Pediatrics·Ayesha N Zia, Meera Chitlur
Oct 4, 2008·Best Practice & Research. Clinical Anaesthesiology·Walter ZinggBernhard Walder
Sep 1, 2015·Annals of Oncology : Official Journal of the European Society for Medical Oncology·B SousaUNKNOWN ESMO Guidelines Committee
Mar 17, 2011·The Biochemical Journal·Charles S CraikEdwin L Madison
Jun 16, 2015·Nursing Research and Practice·Godelieve Alice Goossens
Jun 16, 2006·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·A SimonK Beutel
May 6, 2016·Clinical & Translational Oncology : Official Publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico·I García EscobarUNKNOWN Cancer&Thrombosis Working Group of the Spanish Society of Medical Oncology (SEOM)
Sep 25, 2016·The Journal of Surgical Research·Aurelia B FuAdam C Alder
Jan 1, 2008·JPEN. Journal of Parenteral and Enteral Nutrition·Vered KakzanovAnthony K C Chan
Nov 25, 2005·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Elizabeth A Krzywda, Deborah A Andris
Nov 1, 2005·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Abderrahman AbdelkefiAbdeladhim Ben Abdeladhim
Mar 11, 2009·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Simone CesaroModesto Carli
Mar 6, 2013·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Charles A SchifferMark Levine
Sep 30, 2006·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Janna M Journeycake, George R Buchanan
May 16, 2006·Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie·B Marciniak
Jan 9, 2016·JPEN. Journal of Parenteral and Enteral Nutrition·Melissa A ShenepJoshua Wolf
Nov 15, 2017·Journal of Pediatric Gastroenterology and Nutrition·Lynn M MalecMargaret V Ragni
Jun 27, 2013·The Cochrane Database of Systematic Reviews·Reineke A SchootMarianne D van de Wetering
Oct 11, 2014·The Cochrane Database of Systematic Reviews·Eduardo López-BrizAmanda Burls
Sep 13, 2013·The Cochrane Database of Systematic Reviews·Reineke A SchootCornelia H van Ommen
Jun 2, 2018·The Cochrane Database of Systematic Reviews·Lara A KahaleElie A Akl
Oct 16, 2014·The Cochrane Database of Systematic Reviews·Elie A AklHolger Schünemann
Oct 19, 2013·Journal of Paediatrics and Child Health·Ana de Lorenzo-PintoMaría Sanjurjo-Sáez
Oct 16, 2013·Expert Review of Hematology·Uma Athale
May 16, 2014·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Frank R ErnstAlpesh N Amin
Nov 25, 2006·Hematology·Reinhard Schneppenheim, Jeanette Greiner
Dec 14, 2018·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·Lucas A MutchMelanie L Graham

❮ Previous
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