A GAVeCeLT Project: The Development of a Consensus on the Most Appropriate Lock Solution for Central Venous Catheters

2015 ◽  
Vol 20 (4) ◽  
pp. 240-241
Author(s):  
Mauro Pittiruti
Keyword(s):  
Central Venous Catheters ◽  
Central Venous ◽  
Lock Solution

Heparin Locking for Central Venous Catheters

2006 ◽  
Vol 11 (4) ◽  
pp. 224-231 ◽  
Author(s):  
Lynn Hadaway
Keyword(s):  
Health Care ◽  
Literature Review ◽  
Health Care Professionals ◽  
New Technology ◽  
Central Venous Catheters ◽  
Central Venous ◽  
Lock Solution ◽  
Continued Use ◽  
Careful Assessment ◽  
Heparin Lock

Abstract Traditionally, heparin-lock solution has been used with all central venous catheters. The introduction of new technology calling for the elimination of heparin and the growing concerns about the use of heparin have caused many health care professionals to question its continued use for this purpose. This literature review attempts to answer the most common questions using available research; however, there continues to be more questions than answers. At present, it appears that some farm of anticoagulant will produce more patent catheters, and heparin-lock solution is the only product commercially available. This situation drives the need for a careful assessment of patients' needs prior to abandoning the use of heparin.

scholarly journals Successful Salvage of Central Venous Catheters in Patients with Catheter-Related or Central Line-Associated Bloodstream Infections by Using a Catheter Lock Solution Consisting of Minocycline, EDTA, and 25% Ethanol

2016 ◽  
Vol 60 (6) ◽  
pp. 3426-3432 ◽  
Author(s):  
Issam Raad ◽  
Anne-Marie Chaftari ◽  
Ramia Zakhour ◽  
Mary Jordan ◽  
Zanaib Al Hamal ◽  
...  
Keyword(s):  
Animal Studies ◽  
Bloodstream Infections ◽  
Central Line ◽  
Infectious Complications ◽  
Central Venous Catheters ◽  
Control Group ◽  
Central Venous ◽  
Systemic Antibiotic Therapy ◽  
Lock Solution

In cancer patients with long-term central venous catheters (CVC), removal and reinsertion of a new CVC at a different site might be difficult because of the unavailability of accessible vascular sites.In vitroand animal studies showed that a minocycline-EDTA-ethanol (M-EDTA-EtOH) lock solution may eradicate microbial organisms in biofilms, hence enabling the treatment of central line-associated bloodstream infections (CLABSI) while retaining the catheterin situ. Between April 2013 and July 2014, we enrolled 30 patients with CLABSI in a prospective study and compared them to a historical group of 60 patients with CLABSI who had their CVC removed and a new CVC inserted. Each catheter lumen was locked with an M-EDTA-EtOH solution for 2 h administered once daily, for a total of 7 doses. Patients who received locks had clinical characteristics that were comparable to those of the control group. The times to fever resolution and microbiological eradication were similar in the two groups. Patients with the lock intervention received a shorter duration of systemic antibiotic therapy than that of the control patients (median, 11 days versus 16 days, respectively;P< 0.0001), and they were able to retain their CVCs for a median of 74 days after the onset of bacteremia. The M-EDTA-EtOH lock was associated with a significantly decreased rate of mechanical and infectious complications compared to that of the CVC removal/reinsertion group, who received a longer duration of systemic antimicrobial therapy. (This study has been registered at ClinicalTrials.gov under registration no. NCT01539343.)

scholarly journals Impact of Different Catheter Lock Strategies on Bacterial Colonization of Permanent Central Venous Hemodialysis Catheters

2013 ◽  
Vol 34 (12) ◽  
pp. 1314-1317 ◽  
Author(s):  
Stefan Erb ◽  
Andreas F. Widmer ◽  
Sarah Tschudin-Sutter ◽  
Ursula Neff ◽  
Manuela Fischer ◽  
...  
Keyword(s):  
Sodium Chloride ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Bacterial Colonization ◽  
Hemodialysis Patients ◽  
Central Venous Catheters ◽  
Catheter Colonization ◽  
Central Venous ◽  
Lock Solution ◽  
Catheter Lock

Thirty-nine hemodialysis patients with permanent central venous catheters were analyzed for bacterial catheter colonization comparing different catheter-lock strategies. The closed needleless Tego connector with sodium chloride lock solution was significantly more frequently colonized with bacteria than the standard catheter caps with antimicrobially active citrate lock solution (odds ratio, 0.22 [95% confidence interval, 0.07–0.71]; P = .011).

Salvage of Long-Term Central Venous Catheters During an Outbreak ofPseudomonas putidaandStenotrophomonas maltophiliaInfections Associated With Contaminated Heparin Catheter-Lock Solution

2008 ◽  
Vol 29 (2) ◽  
pp. 125-130 ◽  
Author(s):  
M. Beatriz Souza Dias ◽  
Alina Bernardes Habert ◽  
Vera Borrasca ◽  
Valeska Stempliuk ◽  
Aina Ciolli ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Central Venous Catheters ◽  
High Response Rate ◽  
Care Hospital ◽  
Central Venous ◽  
Blood Samples ◽  
Asymptomatic Patients ◽  
Lock Solution ◽  
Catheter Lock

Objective.To describe the management of patients with long-term central venous catheters (CVCs) during an outbreak of infection due toPseudomonas putidaandStenotrophomonas maltophiliaassociated with contaminated heparin catheter-lock solution.Design.Descriptive study.Setting.Private, 250-bed tertiary-care hospital.Methods.In March 2003, we identified 2 febrile cancer patients withP. putidabacteremia. Over 2 days, 7 cases of bacteremia were identified; lots of syringes prefilled with heparin catheter-lock solution, supplied by a compounding pharmacy, were recalled and samples were cultured. More cases of bacteremia appeared during the following days, and any patient who had had a catheter lock infused with the suspect solution was asked to provide blood samples for culture, even if the patient was asymptomatic. Isolates that were recovered from culture were typed by pulsed-field gel electrophoresis. Antimicrobial salvage treatment of long-term CVCs was attempted.Results.A total of 154 patients had had their catheter lock infused with solution from the lots that were suspected of being contaminated. Only 48 of these patients had CVCs. By day 7 of the outbreak, 18 of these patients had become symptomatic. Twenty-six of the remaining 30 asymptomatic patients then also provided blood samples for culture, 10 of whom developed fever shortly after samples were collected. Thirty-two patients were identified who hadP. putidabacteremia; 9 also had infection due toS. maltophilia. Samples from 1 of the 3 lots of prefilled syringes in use at the time of the outbreak also grewP. putidaon culture. Molecular typing identified 3 different clones ofP. putidafrom patients and heparin catheter-lock solution, and 1 clone ofS. maltophilia. A total of 27 patients received antimicrobial therapy regimens, some of which included decontamination of the catheter lock with anti-infective lock solution. Of 27 patients, 19 (70%) retained their long-term CVC during the 6-month follow-up period.Conclusions.To our knowledge, this is one of the largest prospective experiences in the management of bloodstream infection associated with long-term CVCs. The infections were caused by gram-negative bacilli and were managed without catheter removal, with a high response rate. We emphasize the risks of using intravenous formulations of medications supplied by compounding pharmacies that produce large quantities of drugs.

Stability of a heparin-free 50% ethanol lock solution for central venous catheters

2007 ◽  
Vol 13 (1) ◽  
pp. 33-37 ◽  
Author(s):  
Marcia Pomplun ◽  
Jeremy J. Johnson ◽  
Susan Johnston ◽  
Jill M Kolesar
Keyword(s):  
Central Venous Catheters ◽  
Central Venous ◽  
Lock Solution ◽  
Ethanol Lock
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