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use of tpa(Cathflo)to declot central catheters in patients with epidural catheters in place

Do any of you have a policy addressing the use of tpa for venous cath clearance when the patient has an epidural catheter in place?  Do you have protocols for use of tpa for catheter clearance?  I seem to remember reading somewhere that the 2mg/2ml tpa instillation dose was not enough to affect systemic bleeding/clotting times.  Any info greatly appreciated!

 

Gwen Irwin
use of tpa(Cathflo)to declot central catheters in patients with

Our policy doesn't specify individual situations for alteplase usage, because it isn't necessary.  If the lumen is totally occluded, the patient doesn't get anything systemically.  If the lumen has withdrawal occlusion, then the patient does get a tiny dose.  But you are right the trials indicated no change in systematic bleeding times.

I would refer to

  • www.cathflo.com
  • Gwen Irwin

    Austin, Texas

    lynncrni
    The presence of another

    The presence of another device such as an epidural catheter is not a contraindication to use low-dose tPA to declot a CVC. You should learn more about tPA at www.cathflo.com. Look for information on the drug mechanism of action and half-life. You will find that it is very short and there have been not issues with systemic anticoagulation with this instillation process. Lynn

    Lynn Hadaway, M.Ed., RN, BC, CRNI

    Lynn Hadaway Associates, Inc.

    126 Main Street, PO Box 10

    Milner, GA 30257

    Website http://www.hadawayassociates.com

    Office Phone 770-358-7861

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