Sodium citrate 4% versus heparin as a lock solution in hemodialysis patients with central venous catheters

2013 ◽  
Vol 70 (2) ◽  
pp. 131-136 ◽  
Author(s):  
Calantha K. Yon ◽  
Chai L. Low
Keyword(s):  
Sodium Citrate ◽  
Hemodialysis Patients ◽  
Central Venous Catheters ◽  
Central Venous ◽  
Lock Solution

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).

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 Quantification of Lipoteichoic Acid in Hemodialysis Patients With Central Venous Catheters

2018 ◽  
Vol 5 ◽  
Author(s):  
Amy Barton Pai ◽  
Adinoyi Garba ◽  
Paul Neumann ◽  
Alexander J. Prokopienko ◽  
Gabrielle Costello ◽  
...  
Keyword(s):  
Lipoteichoic Acid ◽  
Hemodialysis Patients ◽  
Central Venous Catheters ◽  
Central Venous

Vascular Access Placement Order and Outcomes in Hemodialysis Patients: A Longitudinal Study

2017 ◽  
Vol 46 (4) ◽  
pp. 268-275 ◽  
Author(s):  
Mariana Murea ◽  
W. Mark Brown ◽  
Jasmin Divers ◽  
Shahriar Moossavi ◽  
Todd W. Robinson ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Vascular Access ◽  
Conversion Rate ◽  
Hemodialysis Patients ◽  
Central Venous Catheters ◽  
Failure Rates ◽  
Transition Rates ◽  
Central Venous ◽  
Av Fistulas

Background: Arteriovenous accesses (AVA) in patients performing hemodialysis (HD) are labeled “permanent” for AV fistulas (AVF) or grafts (AVG) and “temporary” for tunneled central venous catheters (TCVC). Durability and outcomes of permanent vascular accesses based on the sequence in which they were placed or used receives little attention. This study analyzed longitudinal transitions between TCVC-based and AVA-based HD outcomes according to the order of placement. Methods: All 391 patients initiating chronic HD via a TCVC between 2012 and 2013 at 12 outpatient academic dialysis units were included in this study. Chronological distributions of HD vascular accesses were recorded over a mean (SD) of 2.8 (0.9) years and sequentially grouped into periods for TCVC-delivered and AVA-delivered (AVF or AVG) HD. Primary AVA failure and cumulative access survival were evaluated based on access placement sequence and type, adjusting for age. Results: In total, 92.3% (361/391) of patients underwent 497 AVA placement surgeries. Analyzing the initial 3 surgeries, primary AVF failure rates increased with each successive fistula placement (p = 0.008). Among the 82.9% (324/391) of TCVC patients successfully converted to an AVA, 30.9% returned to a TCVC, followed by a 58.0% conversion rate to another AVA. Annual per-patient vascular access transition rates were 2.02 (0.09) HD periods using a TCVC and 0.54 (0.03) HD periods using an AVA. Comparing the first AVA used with the second, cumulative access survivals were 701.0 (370.0) vs. 426.5 (275.0) days, respectively. Excluding those never converting to an AVF or AVG, 169 (52.2%) subsequently converted from a TCVC to a permanent access and received HD via AVA for ≥80% of treatments. Conclusions: HD vascular access outcomes differ based on the sequence of placement. In spite of frequent AVA placements, only half of patients effectively achieved a “permanent” vascular access and used an AVA for the majority of HD treatments.

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.)

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