I.V. ROUNDS: Keeping catheters clear with low-dose warfarin

October 2004 
Volume 34  Number 10
Pages 73 - 73
  PDF Version Available!



    RALPH ADAMS, 69, who has a history of lung cancer, was just admitted to your unit with possible pneumonia. He has an implanted port on the right side of his upper chest. In his chart, you see an order for 1 mg of warfarin daily—an extremely small dose. Mr. Adams doesn't have atrial fibrillation or a history of thromboembolism. So why is he receiving this drug?

    The small dose of warfarin is indicated to guard against catheter-related thrombosis, a common cause of catheter malfunction. Cancer leads to a hypercoagulable state, especially in patients with solid tumors. The presence of any central venous catheter adds to the risk of thrombus formation.

    Catheter-related thrombosis limits the life of a central venous catheter, decreases the catheter's usefulness, and interrupts infusion therapy. Catheter-related thrombi can also spawn dangerous pulmonary emboli. Despite many unanswered questions, a growing body ...

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