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Chemical Phlebothrombosis of Large Veins

Chemical Phlebothrombosis of Large Veins Abstract To the Editor.—Freund reported five cases of phlebothrombosis of large veins among 200 patients who received hyperalimentation via polyvinyl catheters (Archives 1981; 116:1220-1221). He reported that phlebography was performed in only two of these patients, and thrombosis of the subclavian vein was demonstrated. It has been suggested that even in patients without clinical evidence of large-vein thrombosis, evidence of clot formation can be detected in about 60% of the cases if phlebography is routinely performed at the time of removal of the catheter.1 I suggest addition of 1,000 to 2,000 units of heparin sodium to each liter of hyperalimentation solution. This has been shown to diminish thrombus formation on central catheter tips.2 Also, addition of heparin decreases the incidence of catheter sepsis.3 Catheter sepsis usually implies either infection of the fibrin sleeve or thrombus within or around the catheter; therefore, addition of heparin to total parenteral References 1. Brismar B, Hardstedt C, Malmborg AS: Bacteriology and phlebography in catheterization for parenteral nutrition . Acta Chir Scand 1980;146:115-119. 2. Feldtman RW, Andrassy RJ: Total parenteral nutrition . Postgrad Med 1979;64:64-77. 3. Wood M, Wood AJ: Reduction of catheterassociated sepsis in parenteral nutrition using heparin . Br Med J 1979;2:611-612.Crossref 4. Brunzell J, Chait A, Bierman E: Pathophysiology of lipoprotein transport . Metabolism 1978;27:1109-1127.Crossref 5. Bergrem H, Leivestad T: Dialysis death and increased free fatty acids . Lancet 1978;2:1160.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Chemical Phlebothrombosis of Large Veins

Archives of Surgery , Volume 117 (7) – Jul 1, 1982

Chemical Phlebothrombosis of Large Veins

Abstract

Abstract To the Editor.—Freund reported five cases of phlebothrombosis of large veins among 200 patients who received hyperalimentation via polyvinyl catheters (Archives 1981; 116:1220-1221). He reported that phlebography was performed in only two of these patients, and thrombosis of the subclavian vein was demonstrated. It has been suggested that even in patients without clinical evidence of large-vein thrombosis, evidence of clot formation can be detected in about 60% of the cases if...
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Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1982.01380310088026
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor.—Freund reported five cases of phlebothrombosis of large veins among 200 patients who received hyperalimentation via polyvinyl catheters (Archives 1981; 116:1220-1221). He reported that phlebography was performed in only two of these patients, and thrombosis of the subclavian vein was demonstrated. It has been suggested that even in patients without clinical evidence of large-vein thrombosis, evidence of clot formation can be detected in about 60% of the cases if phlebography is routinely performed at the time of removal of the catheter.1 I suggest addition of 1,000 to 2,000 units of heparin sodium to each liter of hyperalimentation solution. This has been shown to diminish thrombus formation on central catheter tips.2 Also, addition of heparin decreases the incidence of catheter sepsis.3 Catheter sepsis usually implies either infection of the fibrin sleeve or thrombus within or around the catheter; therefore, addition of heparin to total parenteral References 1. Brismar B, Hardstedt C, Malmborg AS: Bacteriology and phlebography in catheterization for parenteral nutrition . Acta Chir Scand 1980;146:115-119. 2. Feldtman RW, Andrassy RJ: Total parenteral nutrition . Postgrad Med 1979;64:64-77. 3. Wood M, Wood AJ: Reduction of catheterassociated sepsis in parenteral nutrition using heparin . Br Med J 1979;2:611-612.Crossref 4. Brunzell J, Chait A, Bierman E: Pathophysiology of lipoprotein transport . Metabolism 1978;27:1109-1127.Crossref 5. Bergrem H, Leivestad T: Dialysis death and increased free fatty acids . Lancet 1978;2:1160.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Jul 1, 1982

References