OBJECTIVE: This study aimed to examine the influence of oral acetylsalicylic acid on blood fluidity and infusion speed in the cancer patients with Peripherally Inserted Central Catheter (PICC).
BACKGROUND: PICC is placed for prolonged chemotherapy of cancer patients. The fibrin sheaths, which consist of cellular substance and non-cellular substance, generate at the place of insertion and grow down all over the catheter. Finally they cover the vent of the catheter and lead to catheter dysfunctions such as the decrease of infusion speed. In addition, the high viscosity status of cancer patients could lead to acute embolization, which adds to the high risk of death.
DESIGN: Randomized controlled trial.
METHODS: This research was carried out between April 2013 and January 2014 in the second hospital of Xiangya, Central South University in Changsha, China. Initially 96 cancer participants with PICC were chosen and randomly allocated to experimental and control group. The participants of the experimental group were conducted route PICC maintain technique and took acetylsalicylic acid 100 mg per day after dinner, while the control group received route PICC maintain technique only. The infusion speed and hemorheology indexes of the two groups were tested before our study and at the end of the 2nd and 4th months with several instruments.
RESULTS: Repeated measures analysis of variance indicated that taking acetylsalicylic acid orally had significant main effect on high shear blood viscosity and red blood cell deformability index (P < 0.05), and it also had significant main effect as well as time effect on plasma viscosity (P < 0.05); and time had significant main effect as well as interaction effect with oral acetylsalicylic acid on low shear blood viscosity and red blood cell aggregation index (P < 0.05). Repeated measures ANOVA also showed that taking acetylsalicylic acid orally had significant main effect, time effect and interaction effect on infusion speed (P < 0.01).
CONCLUSION: Oral acetylsalicylic acid could improve hemorheology condition and the infusion speed related to fibrin sheath in the cancer patients.
ChenW.F., ZhuH., ZhaoX.Y., et al., Study on the relationship between the choice of different ways of vein infusion and blood vessel protection in breast cancer patients during chemical therapy, Journal of Nurses Training21 (2006), 105–107.
2.
CrainM.R., HortonM.G. and MewissenM.W., Fibrin sheaths complicating central venous catheters, AJR Am J Roentgenol171 (1998), 341–346.
3.
CrainM.R., MewisseM.W., OstrowskiG.J., et al., Fibrin sleeve stripping for salvage of failing hemodialysis catheters: Technique and initial results, Radiology198 (1996), 41–44.
4.
DuanQ.Q., ZhangL.H. and WangB.X., Research progress of histopathologic characteristics and mechanisms of fibrin sheath related to central venous catheter, Chinese Journal of Blood Purification10 (2011), 503–506.
5.
DuanQ.Q., ZhangL.H., ZhangW.Y., et al., The analysis of 28 cases fibrin sheath related to carheter observed by color flow doppler sonography, Chinese Journal of Blood Purification11 (2012), 198–201.
6.
FangX.H., KangJ.L., SongY.H., et al., The clinical observation of hemorheology indexes of patients with bone tumors, The Journal of Traditional Chinese Orthopedics and Traumatology15 (2003), 10–11.
7.
FabienneC.B., PaulaL. and VincentW.C., Peripherally inserted central catheters, Pediatric Emergency Care27 (2011), 556–561.
8.
FaintuchS. and SalazarG.M., Malfunction of dialysis catheters: Management of fibrin sheath and related problems, Tech Vasc Interv Radiol11 (2008), 195–200.
GyawaliP., RichardsR.S., HughesD.L., et al., Erythrocyte aggregation and metabolic syndrome, Clin Hemorheol Microcirc57 (2014), 73–83.
11.
HoshalV.L., AuseR.G. and HoskinsP.A., Fibrin sleeve formation on indwelling subclavian central venous catheters, Arch Surg102 (1971), 353–358.
12.
JungF., BrauneS. and LendleinA., Haemocompatibility testing of biomaterials using human platelets, Clin Hemorheol Microcirc53 (2013), 97–115.
13.
KorbutR.A. and Adamek-GuzikT., The effect of aspirin on rheological properties of erythrocytes in essential hypertension, Przegl Lek59 (2002), 71–75.
14.
MarkW.W., BartonF.I. and ChristineC., The use of inhaled prostacyelin in nitroprusside-resistant pulmonary artery hypertension, J Heart Lung Transplant20 (2001), 1340–1344.
15.
MaX.Q. and TianF.S., The effects of aspirin combined ginkgsbilobaextrct on the blood lipid and hemorrheology in the patients with hyperlipidemia, Hebei Medical Journal32 (2010), 2380–2381.
16.
OliverM.J., MendelssohnD.C., QuinnR.R., et al., Catheter patency and function after catheter sheath disruption: A pilot study, Clin J Am Soc Nephrol2 (2007), 1201–1206.
17.
PappJ., KenyeresP. and TothK., Clinical importance of antiplatelet drugs in cardiovascular diseases, Clin Hemorheol Microcirc53 (2013), 81–96.
18.
QuS.J., WangT., ZhangJ.Q., et al., Effects of the coadministration of Huatuo Zaizao pills and aspirin on hemorrheology and blood coagulation in rabbits, Biomedical Reports1 (2013), 459–463.
19.
ReinhartW.H., Platelets in vascular disease, Clin Hemorheol Microcirc53 (2013), 71–79.
20.
SchonD. and WhittmanD., Managing the complications of long-term tunneled dialysis catheters, Semin Dial16 (2013), 314–322.
21.
SantilliJ., Fibrin sheaths and central venous catheter occlusions: Diagnosis and management, Tech Vasc Interv Radiol5 (2002), 89–94.
22.
StarkhammarH., BengtssonM. and MoralesO., Fibrin sleeve formation after long term brachial catheterisation with an implantable port device. A prospective venographic study, Eur J Surg158 (1992), 481–484.
23.
SuH.H. and WangT.Y., The change of blood rheology of the high blood viscosity patients who took aspirin for a long time, Chinese Journal of Hemorheology16 (2006), 373–374.
24.
TranH., ArellanoM., ChamsuddinA., et al., Deep venous thromboses in patients with hematological malignancies after peripherally inserted central venous catheters, Leuk Lymphoma51 (2010), 1473–1477.
25.
WangJ.P., CuiJ.N., ChenZ.G., et al., The life quality and its influencing factors of the cancer patients, Chinese Journal of Clinical Psychology8 (2000), 23–26.
26.
WangW.L., WuY., SunW., et al., The effects of aspirin on the preventing of the formation of venous thrombosis of the cancer patients, Modern Medicine Journal of China12 (2010), 89.
27.
WeiN., YangC.S. and LiS.F., The effects of ligustrazine on the whole blood viscosity and erythrocyte aggregation index in acute cerebral infarction patients, Journal of Xinxiang Medical College24 (2007), 588–590.
28.
WanX.X., ZhouJ.Y., GuoX.K., et al., The research of blood rheology in patients with malignant tumor with distant metastasis, Chinese Journal of Hemorheology12 (2002), 238–239.
29.
WhighamC.J., LindseyJ.I., GoodmanC.J., et al., Venous port salvage utilizing low dose tPA, Cardiovasc Intervent Radiol25 (2002), 513–516.
30.
WongJ.K., SadlerD.J., McCarthyM., et al., Analysis of early failure of tunneled hemodialysis catheters, Am J Roentgenol179 (2002), 357–363.
31.
XiangD.Z., VerbekenE.K., Van LommelA.T., et al., Composition and formation of the sleeve enveloping a central venous catheter, J Vasc Surg28 (1998), 260–271.
32.
YuG.Q., AL.Y., GuM., et al., The function of the erythrocyte aggregation, plasma viscosity and its protein components in the regulation of blood viscosity, Journal of Chinese Microcirculation8 (2004), 298–300.
33.
ZhaoZ.G., NiuC.Y., LiZ.P., et al., The effects of mesenteric lymph drainage on erythrocyte rheology in rats with hemorrhagic shock, Chin J Appl Physiol28 (2012), 149–153.
34.
ZhouC.L., LiuY.Q. and ChenJ., The effects of aspirin on the prevention of the formation of venous thrombosis of the tumor patients, Anti-tumor Pharmacy2 (2012), 137–139.
