Journal of the American College of Nutrition, Vol 2, Issue 1 63-73, Copyright © 1983 by American College of Nutrition

JOURNAL ARTICLE

Limitation of central vein thrombosis in total parenteral nutrition by continuous infusion of low-dose heparin

J. Imperial, B. R. Bistrian, A. Bothe Jr, M. Bern and G. L. Blackburn

The use of continuous, low-dose heparin in total parenteral nutrition (TPN) formulas to limit central venous thrombosis was retrospectively evaluated. Seven of 129 patients (5.4%) developed central vein thrombosis when TPN solutions provided less than 6,000 units (usually 1,000 units/liter) heparin per day. In the subsequent period when heparin was increased to 6,000 units per day, 10 of 858 (less than 1.2%) patients developed a TPN-related thrombosis (P less than 0.0005). The incidence of antithrombin III (AT III) deficiency in a subset of high-risk patients scheduled to receive TPN was 51% (23 of 55). Twelve of the 23 had clinical evidence of thrombosis, whereas only 3 of 22 patients with normal AT III levels did (P less than 0.01) A major contributing factor to the development of thrombosis in TPN appears to be depression in antithrombin III levels, which is commonly found in patients who require this therapy. Low-dose heparin appears to reduce the incidence of thrombosis with TPN when provided continuously in sufficient amounts.

This article has been cited by other articles:

				O Plan, G Cambonie, E Barbotte, P Meyer, C Devine, C Milesi, O Pidoux, M Badr, and J C Picaud Continuous-infusion vancomycin therapy for preterm neonates with suspected or documented Gram-positive infections: a new dosage schedule Arch. Dis. Child. Fetal Neonatal Ed., November 1, 2008; 93(6): F418 - F421. [Abstract] [Full Text] [PDF]

				V. Kakzanov, P. Monagle, and A. K. C. Chan Thromboembolism in Infants and Children With Gastrointestinal Failure Receiving Long-Term Parenteral Nutrition JPEN J Parenter Enteral Nutr, January 1, 2008; 32(1): 88 - 93. [Abstract] [Full Text] [PDF]

				R. L. K. Shanbhogue, B. R. Bistrian, P. Benotti, and G. L. Blackburn The Nutritional Management of a Patient On Long-Term Mechanical Ventilation Nutr Clin Pract, February 1, 1987; 2(1): 23 - 25. [PDF]