الفهرس 
Central Venous CatheterOnly 14 pages are availabe for public view
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Abstract
Central venous catheter is commonly performed in care of the pediatric patient. There are a multitude of complications that are associated with their placement. Complications can present in an immediate or delayed fashion. Significant morbidity and mortality can result from complications related to central venous access.
We aimed at performing an updated comprehensive systematic review and meta-analysis of the published randomized controlled trials and observational studies on demonstrating the role of unfractionated heparin and low molecular weight heparin in prevention catheter flow thrombotic complications in children with central venous catheter. In addition to the role of taurlodine lock solutions in prevention central line associated blood stream infection in those children with central venous catheter.
Methods: The search conducted in four electronic databases PubMed, Google Scholar, Elsevier’s thrombosis journal, and the Cochrane Central Register for Controlled Trials (CENTRAL) for articles published in peer-reviewed journals from 2000 to December 2018. Furthermore, the titles and abstracts of the studies resulted from the search were screened for the inclusion in the systematic review and the meta-analysis based on the inclusion and exclusion criteria. Included observational studies, and randomized controlled trials are assessed for clinical, laboratory, and imaging characteristics of CVC thrombotic complications
and central line associated blood stream infection. We compared UFH (flushes, lock solutions, continuous infusion, and heparin bonded catheter) to no prophylaxis (saline flush or no treatment), LMWH to UFH infusion, to prevent CVC flow complications (CVC-related thrombosis and/or catheter occlusion), and Taurolidine lock solutions to heparin lock in prevention central line associated blood stream infection. In order to pool data from eligible studies, the meta-analysis was performed on RevMan version 5.3. Odds ratios were generated with the corresponding 95% CI by using the random-effect model. All outcomes were analyzed as dichotomous outcomes. All statistical tests had a significance level of 0.05.
Results: from 413 studied identified, we analyzed 11 articles, eight studies for UFH prophylaxis with 1380 patients. Three studies for LMWH prophylaxis with 320 patients Our results revealed UFH was significantly superior on control group in reducing Occlusion/CRT (odds ratio 0.39, 95% CI: 0.19:0.8) (p 0.01). Also it revealed insignificantly effect of either LMWH or UFH infusion in reducing Occlusion/ CRT(odds ratio 0.9, 95% CI: 0.34:2.36)
(p 0.84).
from 155 studies identified for Taurolidine meta- analysis, five eligable studies with 522 patients were analyzed. Our result revealed that TLS was significantly superior on UFH lock in reducing CLABSI (odds ratio 0.29, 95% CI: 0.13:.0.63) (p 0.002).
Conclusion: The published data support the hypothesis that using of UFH as a thromboprophylaxis may significantly reduce catheter thrombotic complications in pediatric patients with CVC. Low molecular weight heparin not superior to unfractionated heparin infusion in reduction of catheter occlusion and catheter related thrombosis in those children with central venous catheter. Taurolidine lock solution resulted in a significant reduction in central line associated blood stream infection compared with unfractionated heparin lock in pediatric patients with central venous catheter.