Heparinization for prevention of thrombosis following pediatric percutaneous arterial catheterization

Summary

One thousand three hundred and sixteen consecutively catheterized infants and children were evaluated prospectively for femoral artery thrombosis following percutaneous cardiac catheterization. One hundred units/kg heparin bolus was given to 649 patients after arterial puncture (group A). A supplementary 50 units/kg of heparin bolus was given to 381 patients 75 minutes later, followed by a continuous heparin infusion if pulses were decreased (group B). Two hundred forty-one patients were managed similarly except the first supplementary bolus was given 45 minutes after initial heparinization, if necessary, and the second bolus and continuous infusion were begun 45 minutes later, if necessary (group C). Arterial thrombosis was diagnosed if pulses were not equal to those of the unused extremity 6 hours following catheterization.

The overall incidence of arterial thrombosis was 0.8%. No statistically significant (p<.05) differences occurred related to the heparinization method used. However, absence of thrombosis in the last 241 consecutive patients (group C) and in the last 480 patients of groups B and C weighing more than 10 kg approaches significance (p<.1). Incidence of thrombosis was less than in previous studies (p<.0005 to .05). This study indicates that a very low incidence of arterial thrombosis can be achieved with systemic heparinization.