273 VOLUME 5, NUMBER 6 ■ JUNE 2007 www.SupportiveOncology.net J Support Oncol 2007;5:273–278 © 2007 Elsevier Inc. All rights reserved. ORIGINAL RESEARCH Abstract Bloodstream infections related to the use of central venous catheters are an important cause of patient morbidity, mortality, and increased health care costs. Catheter-related infection may be due to fibrin deposition associated with catheters. Interventions designed to decrease fibrin deposition have the potential to reduce catheter-related infections. This study was a randomized, controlled trial in which 246 patients with nontunneled central venous catheters were randomly as- signed to receive a heparin-coated catheter with 50 mL/d of normal sa- line solution as a continuous infusion (heparin-coated group) or a non- coated catheter with a continuous infusion of low-dose unfractionated heparin (control group: continuous infusion of 100 U/kg/d). Catheter-re- lated bloodstream infection occurred in 2.5% (3/120 catheters) in the heparin-coated group (0.9 events per 1,000 days) and in 9.1% (11/120 catheters) in the control group (3.5 events per 1,000 days; P = 0.027). No other risk factors were found for the development of catheter-related bloodstream infection. Six and seven patients experienced severe bleed- ing in the heparin-coated and control groups, respectively (P = 1.00). We did not observe heparin-induced thrombocytopenia. The use of hepa- rin-coated catheters can be a safe and effective approach to the preven- tion of catheter-related bloodstream infection in patients with hemato- oncologic disease. Methods STUDY DESIGN This prospective, randomized, controlled tri- al was conducted between May 2005 and June 2006 at the National Center for Bone Marrow Transplantation in Tunis, Tunisia. The study protocol was approved by the local medical ethical committee. All patients or their legal representatives gave written informed consent before entering the study, which was done in ac- cordance with the Declaration of Helsinki. This study is registered at ClinicalTrials.gov, number NCT00207779. From the Centre National de Greffe de Moelle Osseuse, Tu- nis, Tunisia, and Institut National de la Santé Publique, Tunis, Tunisia. Manuscript submitted August 1, 2006; accepted April 10, 2007. Correspondence to: Abderrahman Abdelkefi, MD, Centre Na- tional de Greffe de Moelle Osseuse, Rue Jebel Lakhdar, 1006 Bab Saadoun, Tunis, Tunisia; telephone: 00216 98 436 516; fax: 00216 71 565 428; e-mail: aabdelkefi@yahoo.fr Use of Heparin-Coated Central Venous Lines to Prevent Catheter- Related Bloodstream Infection Abderrahman Abdelkefi, MD, Wafa Achour, MD, Tarek Ben Othman, MD, Saloua Ladeb, MD, Lamia Torjman, MD, Amel Lakhal, MD, Assia Ben Hassen, MD, Mohamed Hsairi, MD, and Abdeladhim Ben Abdeladhim, MD C entral venous lines (CVLs) are com- monly used in patients with hemato- oncologic disease for hemodynamic monitoring, administration of medica- tion, and parenteral nutrition. 1–5 Complications of catheterization include mechanical (arterial puncture, pneumothorax), thrombotic, and in- fectious complications. 6 Approximately 80,000 central venous cathe- ter-related bloodstream infections (CRBIs), rep- resenting 5.3 infections per 1,000 catheter days, occur annually in intensive care units in the United States. 7 Attributable mortality for these infections ranges from 10% to 25%; each CRBI adds as much as $5,000−$19,000 and 12.5 days to a hospital stay. 8 Studies have shown that catheter-related in- fection may be due to fibrin deposition associated with catheters. 9–11 Interventions designed to de- crease fibrin deposition and thrombus formation have the potential to reduce catheter-related in- fections. Recently, in a randomized, controlled study, we showed that a low-dose of unfraction- ated heparin (UFH; 100 U/kg/d) was a safe and effective way to prevent CRBI in patients with hemato-oncologic disease. 12