Mechanism of thrombogenesis during total parenteral nutrition: role of catheter composition. 1988

J di Costanzo, and B Sastre, and R Choux, and M Kasparian
Clinique de la Résidence du Parc, Marseilles, France.

Catheter material is considered as one of the main factors of deep venous thrombosis during parenteral nutrition. The effects of five types of catheters (polyethylene, polyurethane, silicone, TFE Teflon, and FEP Teflon) on the vein wall and on the blood flow were compared. Experiments were performed on rabbits in which catheters were inserted into the vena cava. Five series of experiments were performed, each including five animals with the same type of catheter. After 10 days, venograms of the vena cava were performed, animals were then killed and the vena cava was removed with the catheter in situ. The vein and the catheter were macroscopically examined; in cases with thrombosis the clot was weighed. The vein wall and the catheter were examined by conventional microscopy and by electron microscopy, respectively. Obstruction of the venous lumen were significantly more frequent with the rigid catheters than with the soft catheters (p less than 0.001). The most extensive thromboses occurred with the Teflon catheters. The incidence of fibrin sleeves was significantly higher with the soft catheters than with the rigid ones (p less than 0.01). The venographic and macroscopic findings were in agreement in 60-100% of the cases according to the degree of venous obstruction. Catheter surfaces remained unchanged in all cases. The polyethylene catheters induced the most severe intimal inflammatory reactions. Thrombus formation was caused by two mechanisms depending on catheter composition: (1) turbulence caused by the catheter in the blood stream, and (2) platelet aggregation and subsequently, fibrin deposition on the surface of the catheter.

UI MeSH Term Description Entries
D008854 Microscopy, Electron Microscopy using an electron beam, instead of light, to visualize the sample, thereby allowing much greater magnification. The interactions of ELECTRONS with specimens are used to provide information about the fine structure of that specimen. In TRANSMISSION ELECTRON MICROSCOPY the reactions of the electrons that are transmitted through the specimen are imaged. In SCANNING ELECTRON MICROSCOPY an electron beam falls at a non-normal angle on the specimen and the image is derived from the reactions occurring above the plane of the specimen. Electron Microscopy
D010289 Parenteral Nutrition, Total The delivery of nutrients for assimilation and utilization by a patient whose sole source of nutrients is via solutions administered intravenously, subcutaneously, or by some other non-alimentary route. The basic components of TPN solutions are protein hydrolysates or free amino acid mixtures, monosaccharides, and electrolytes. Components are selected for their ability to reverse catabolism, promote anabolism, and build structural proteins. Hyperalimentation, Parenteral,Intravenous Hyperalimentation,Nutrition, Total Parenteral,Parenteral Hyperalimentation,Total Parenteral Nutrition,Hyperalimentation, Intravenous
D010974 Platelet Aggregation The attachment of PLATELETS to one another. This clumping together can be induced by a number of agents (e.g., THROMBIN; COLLAGEN) and is part of the mechanism leading to the formation of a THROMBUS. Aggregation, Platelet
D011095 Polyethylenes Synthetic thermoplastics that are tough, flexible, inert, and resistant to chemicals and electrical current. They are often used as biocompatible materials for prostheses and implants. Ethylene Polymers,Ethene Homopolymers,Homopolymers, Ethene,Polymers, Ethylene
D011138 Polytetrafluoroethylene Homopolymer of tetrafluoroethylene. Nonflammable, tough, inert plastic tubing or sheeting; used to line vessels, insulate, protect or lubricate apparatus; also as filter, coating for surgical implants or as prosthetic material. Synonyms: Fluoroflex; Fluoroplast; Ftoroplast; Halon; Polyfene; PTFE; Tetron. FEP,Fluon,Politef,Polytef,TFE,Teflon,Expanded PTFE,Fluoroplast,GORE-TEX,Goretex,PTFE,Tarflen,GORE TEX,PTFE, Expanded
D011140 Polyurethanes A group of thermoplastic or thermosetting polymers containing polyisocyanate. They are used as ELASTOMERS, as coatings, as fibers and as foams. Polyisocyanates,Ostamer,Pellethane,Spandex,Ostamers,Pellethanes,Polyisocyanate,Polyurethane,Spandices
D011817 Rabbits A burrowing plant-eating mammal with hind limbs that are longer than its fore limbs. It belongs to the family Leporidae of the order Lagomorpha, and in contrast to hares, possesses 22 instead of 24 pairs of chromosomes. Belgian Hare,New Zealand Rabbit,New Zealand Rabbits,New Zealand White Rabbit,Rabbit,Rabbit, Domestic,Chinchilla Rabbits,NZW Rabbits,New Zealand White Rabbits,Oryctolagus cuniculus,Chinchilla Rabbit,Domestic Rabbit,Domestic Rabbits,Hare, Belgian,NZW Rabbit,Rabbit, Chinchilla,Rabbit, NZW,Rabbit, New Zealand,Rabbits, Chinchilla,Rabbits, Domestic,Rabbits, NZW,Rabbits, New Zealand,Zealand Rabbit, New,Zealand Rabbits, New,cuniculus, Oryctolagus
D002408 Catheters, Indwelling Catheters designed to be left within an organ or passage for an extended period of time. Implantable Catheters,In-Dwelling Catheters,Catheter, In-Dwelling,Catheter, Indwelling,Catheters, In-Dwelling,In Dwelling Catheters,In-Dwelling Catheter,Indwelling Catheter,Indwelling Catheters
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D001672 Biocompatible Materials Synthetic or natural materials, other than DRUGS, that are used to replace or repair any body TISSUES or bodily function. Biomaterials,Bioartificial Materials,Hemocompatible Materials,Bioartificial Material,Biocompatible Material,Biomaterial,Hemocompatible Material,Material, Bioartificial,Material, Biocompatible,Material, Hemocompatible

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