Prophylaxis with urokinase in pediatric oncology patients with central venous catheters

This study evaluated the effects of urokinase in the prevention of central venous catheter (C VC)related complications in children with maligwancy. Fifteen Patients with 16 CVCs (study group A) received (in intraluminal application of urokinase (10, 000 IU in each catheter In men for 4 h) once a week. They were monitored prospectively, with quantitative blood cultures and ultrasonographly (color Doppler ultrasound of the great veins and echocardiography). The rate of complications was compared with that of 15 children with 19 CVCs without thromboprophlaxis, treated the previous year (control group B). The authors found a significantly lower incidence of CVC dysfunction (3/16 versus 13/19), no major thrombosis, fewer CVC-related bacteremias (2/16 versus 8/19). and a higher salvage of CVCs (1/16 venus 5/19 CVC removals due to persistent bacteremia) in the thromboprophylaxis group. Asymptontatic thrombosis rate was also lower (7/16 cases in group A versus 9/11 in group B when sonography was performed). No hemorrhogic complications were noted. Thromboprophylaxis with workinase seems a safe and effective measure for reducing the rate of CVC-related complications.