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

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)

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