2008 SOR guidelines for the prevention and treatment of thrombosis associated with central venous catheters in patients with cancer: report from the working group.
2009
Debourdeau, P. | Kassab Chahmi, D. | Le Gal, G. | Kriegel, I. | Desruennes, E. | Douard, M.-C. | Elalamy, I. | Meyer, G. | Mismetti, P. | Pavic, M. | Scrobohaci, M.-L. | Lévesque, H. | Renaudin, J. M. | Farge, D. | Renseigné, Non | Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO) ; Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM) ; Université de Brest (UBO)-Université de Brest (UBO) | Signalisation cellulaire, dynamique circulatoire et athérosclérose précoce (SCDCAP) ; Centre National de la Recherche Scientifique (CNRS) | Ecole Vétérinaire de Toulouse ; Ecole Vétérinaire de Toulouse | Groupe de recherche sur la thrombose, pharmacologie des antithrombotiques et situations à risque (GRT) ; Université Jean Monnet - Saint-Étienne (UJM) | Service de Médecine Interne [CHU Rouen] ; CHU Rouen ; Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN) ; Normandie Université (NU) | Génomique, développement et pouvoir pathogène (GD2P) ; Université Bordeaux Segalen - Bordeaux 2-Institut National de la Recherche Agronomique (INRA) | Bases Moleculaires de l'Homeostasie Cutanee : Inflammation, Reparation et Cancer ; Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)
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Показать больше [+] Меньше [-]Английский. BACKGROUND: In view of the lack of recommendations on central venous catheter (CVC)-associated thrombosis in cancer patients, we established guidelines according to the well-standardized Standards, Options and Recommendations methodology. Material and methods: A literature review (1990-2007) on CVC-associated thrombosis was carried out. The guidelines were developed on the basis of the corresponding levels of evidence derived from analysis of the 36 of 175 publications selected. They were then peer reviewed by 65 independent experts. RESULTS: For the prevention of CVC-associated thrombosis, the distal tip of the CVC should be placed at the junction between the superior cava vein and right atrium; anticoagulants are not recommended. Treatment of CVC-associated thrombosis should be based on the prolonged use of low-molecular weight heparins. Maintenance of the catheter is justified if it is mandatory, functional, in the right position, and not infected, with a favorable clinical evolution under close monitoring; anticoagulant treatment should then be continued as long as the catheter is present. CONCLUSIONS: Several rigorous studies do not support the use of anticoagulants for the prevention of CVC-associated thrombosis. Treatment of CVC-associated thrombosis relies on the same principles as those applied in the treatment of established thrombosis in cancer patients.
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