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Lookup NU author(s): Dr Louise MacDougall,
Dr John Hanley,
Dr Nicholas Thompson
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© Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/. Background Maintaining central access is imperative for the delivery of home parenteral nutrition (HPN) in those with intestinal failure. Methods to reduce central venous catheter infection are well recognised; however, the prevention of line thrombosis is less well studied. Methods This paper reviews the current evidence and reports a survey of current practice within the UK. Using an electronic survey, respondents were asked to detail their use of anticoagulation in different patient groups and the type of anticoagulation used. Results 41 replies were received from 31 centres. Only one responder used low-dose warfarin routinely; 80% however anticoagulated those with a previous line thrombosis and 65% anticoagulated those that had any deep vein thrombosis or pulmonary embolus. The most commonly used anticoagulant was dose-adjusted warfarin aiming for an international normalised ratio of 2-3. Conclusions The evidence from the current literature in both HPN and the wider field is that there is no clear evidence that anticoagulation is either beneficial or harmful in the prevention of line thrombosis. This survey suggested that practice is varied across the UK likely reflecting the lack of evidence within the current literature.
Author(s): Macdougall L, Hanley J, Mountford C, Thompson NP
Publication type: Review
Publication status: Published
Journal: Frontline Gastroenterology
Print publication date: 01/07/2017
Online publication date: 06/01/2017
Acceptance date: 20/12/2016
ISSN (print): 2041-4137
ISSN (electronic): 2041-4145
Publisher: BMJ Publishing Group