Abstract
The presence of silastic prostheses and tubing in the circulation is now recognized to produce alterations in hemostasis. Stimulated by the observation of severe disseminated intravascular coagulation in a child with a clotted V.J. shunt and the recognition that obstruction to such catheters is one of the undesirable complications of its use in children with hydrocephalus, coagulation studies were performed in 25 asymptomatic children with V.J. shunts. Prothrombin and partial thromboplastin times, Factor V and VIII levels and platelet counts were normal in all. In 2 of the patients the thrombin time was prolonged and in 1 of these patients significant increases in the level of fibrin split products were demonstrable. In 4 patients platelet survivals, using Cr51 labeled platelets, were performed. In 2 the survival was; significantly reduced. Patients in whom coagulation abnormalities or shortened platelet survival were present developed obstructive complications in their shunts. It would appear that catheter problems can be anticipated by performance of coagulation studies. The use of aspirin and dipyridamole, agents which inhibit platelet aggregation in vivo, may provide a means. of eliminating the complication of shunt obstruction.
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Stuart, M., Stockman, J., Murphy, S. et al. Coagulation abnormalities in patients with hydrocephalus and ventricular-jugular. Pediatr Res 5, 374 (1971). https://doi.org/10.1203/00006450-197108000-00014
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DOI: https://doi.org/10.1203/00006450-197108000-00014