I was excited to hear the lecture on Reducing the risk of cather related thrombosis at the recent AVA confernce.
Dr Nifong had made a specific reference on treatment of the thrombosis which started with identifying as a DVT or not; If thrombosis is below the axilla , it is not a DVT and recommends conservative management along with catheter removal. He warn of a possible recurrence or extension and risk of PE with catheter removal. I was so excited to see that specific recommendation. I promptly went and pulled up a copy of the article he references for that statement; American College of Chest Physicians Evidence Based clinical Practice Guideline Chest 2008 Supplement.
I can not find anywhere where it mentions that; Management of a catheter related superficial venous thrombosis It makes much mention of SVT but not related to catherter provoked, only spontaneous SVT which woudl be different.
I did find where it mentions treatment of DVT and anticoagulation for DVT related to a central line in the upper extremity , ( it includes the brachial vein; is that just the small portion above the axilla where it joins to the subclavian? since we are saying it must be above axilla to be considered a DVT)
For an UEDVT; he also recommends to NOT remove the catheter if it is still functioning and needed. This also I could not find anywhere.
Can anyone help me with this info. I would like to discuss this recommended plan of care with my physicians.
thank you in advance, Gina Ward R.N.