• Med. Klin. (Munich) · May 2009

    Multicenter Study Clinical Trial

    Low levels of prothrombin time (INR) and platelets do not increase the risk of significant bleeding when placing central venous catheters.

    • Kilian Weigand, Jens Encke, F Joachim Meyer, Ulrich Paul Hinkel, Markus Munder, Wolfgang Stremmel, and Alexandra Zahn.
    • Medizin IV, Department of Gastroenterology and Hepatology, University Hospital Heidelberg, Heidelberg, Germany. kilian_weigand@med.uni-heidelberg.de
    • Med. Klin. (Munich). 2009 May 15;104(5):331-5.

    Background And PurposeCentral venous catheters are frequently placed in intensive care medicine for multiple indications. The risk of severe bleeding after cannulation is considered to be increased in patients with abnormal coagulation, common in critically ill patients.Patients And MethodsThis open prospective trial, performed at two medical intensive care units and one hematology intermediate care ward, investigated whether insertion of a central venous catheter in patients with coagulopathy (prothrombin time or= 1.5] and/or platelets ResultsIn 196 patients with and without severe disorders of hemostasis, no significant difference in decrease of hemoglobin after catheter placement was observed. In addition, no correlation between a significant drop in hemoglobin and increased levels of creatinine or urea was seen. Mechanical complications were similar in frequency compared to previous publications.ConclusionThese findings demonstrate that coagulation disorders with altered prothrombin time (INR) or platelets do not increase the risk of significant bleeding when inserting a central venous catheter. Therefore, the prophylactic correction of coagulation by transfusion of blood products or coagulation factors is not necessary before central venous catheter insertion.

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