Zain A AlRstum1, Tam T Huynh2, Steven Y Huang3, George T Pisimisis4. 1. Department of Cardiovascular & Thoracic Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, United States. 2. Department of Cardiovascular & Thoracic Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, United States; Department of Interventional Radiology, University of Texas MD Anderson Cancer Center, Houston, TX, United States. 3. Department of Interventional Radiology, University of Texas MD Anderson Cancer Center, Houston, TX, United States. 4. Department of Cardiovascular & Thoracic Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, United States; Department of Interventional Radiology, University of Texas MD Anderson Cancer Center, Houston, TX, United States. Electronic address: gpisimisis@mdanderson.org.
Abstract
INTRODUCTION: We sought to assess the incidence and risk factors of bleeding after ultrasound-guided internal jugular (USGIJ) catheter insertion in severely thrombocytopenic cancer patients, as safe platelet (PLT) count threshold remains controversial. METHODS: Retrospective study of 52 patients with hematologic malignancies and severe thrombocytopenia who underwent USGIJ catheter insertion between 2014 and 2016. Group A included patients with prophylactic PLT transfusion and Group B without. Statistical analysis was performed. RESULTS: Group A included 28 patients and Group B 24. Baseline characteristics were equally distributed. Median catheter size was 12 Fr and tunneled in 20/52 patients. Median PLT count was not statistically different between the groups, before transfusion and after the procedure. Postoperative minor bleeding occurred in 10/52 patients, similar between groups. Lower PLT count, larger catheter caliber and trend for AML diagnosis were identified as risk factors for bleeding. Age, gender, BMI, renal dysfunction and tunneled insertion were not significant. CONCLUSION: Incidence of minor bleeding is low in severely thrombocytopenic patients after USGIJ catheter insertion. Prophylactic platelet transfusion may be reserved for patients with identified risk factors.
INTRODUCTION: We sought to assess the incidence and risk factors of bleeding after ultrasound-guided internal jugular (USGIJ) catheter insertion in severely thrombocytopenic cancerpatients, as safe platelet (PLT) count threshold remains controversial. METHODS: Retrospective study of 52 patients with hematologic malignancies and severe thrombocytopenia who underwent USGIJ catheter insertion between 2014 and 2016. Group A included patients with prophylactic PLT transfusion and Group B without. Statistical analysis was performed. RESULTS: Group A included 28 patients and Group B 24. Baseline characteristics were equally distributed. Median catheter size was 12 Fr and tunneled in 20/52 patients. Median PLT count was not statistically different between the groups, before transfusion and after the procedure. Postoperative minor bleeding occurred in 10/52 patients, similar between groups. Lower PLT count, larger catheter caliber and trend for AML diagnosis were identified as risk factors for bleeding. Age, gender, BMI, renal dysfunction and tunneled insertion were not significant. CONCLUSION: Incidence of minor bleeding is low in severely thrombocytopenicpatients after USGIJ catheter insertion. Prophylactic platelet transfusion may be reserved for patients with identified risk factors.
Authors: Roxana Amirahmadi; Scott Sullivan; Noel Britton; Ariel Siegel; Rory Spiegel; Jennifer Miceli; Vu Duong; Jeffrey T Sholander; Magali J Fontaine; Michael T McCurdy Journal: Ann Hematol Date: 2022-06-28 Impact factor: 4.030