Authors (including presenting author) :
MAK SY, CHAN HY, CHIU SY, HO WM, KAN MS
Affiliation :
Department of Pediatrics and Adolescent Medicine, Queen Mary Hospital
Introduction :
There are few data to discuss about management of occluded central venous access device (CVAD) in children, as well as dose of thrombolytic agent, dwell-time, and safety issue.
Objectives :
The objective of the study is to review the safety of current practise on the use of urokinase for partial occlusion of CVAD in children, and to develop a guideline on management of pediatric CVAD occlusion.
Methodology :
This is a three year retrospective single-center review of management on partial occlusion of central venous access devices between 2016-2018. The types of CVAD, number of lumens blocked, concentration of urokinase used, indwelling time of urokinase lock, CVAD patency post-urokinase and patients' bleeding condition were recorded and analyzed.
Result & Outcome :
There were a total of 54 affected catheters (42 Hickmann, 5 Broviac, 7 PICC) and 74 episodes on partial blockages. Each episodes defined as per lumen blockage. 17 episodes of partial blockages (6 Hickmann, 1 Broviac, 6 PICC) happened within 1 month of CVAD insertion. 52 occluded catheters were managed by dwelling low dose lock of urokinase 3000 unit per mL over 24 hours. 2 catheters were locked for less than 4 hours to facilitate multiple infusions of treatment regimen. 1 catheter was locked for over 3 days adjusted to patients’ home leave schedule. 3 catheters required repeated urokinase lock. Majority of the catheter blood withdrawal patency was restored, except 2 catheters needed to be reinserted due to kinking and malposition respectively. No patients encountered bleeding problems within the period of urokinase lock. Managing partial occluded CVAD with low dose urokinase lock in children was simple, safe and effective. No serious side effect was reported.
Co-location with:
