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Cvc lock solutions

Maria C Arechabala, Maria I Catoni, Juan Carlos Claro, Noelia P Rojas, Miriam E Rubio, Mario A Calvo, Luz M Letelier
BACKGROUND: Patients undergoing haemodialysis (HD) through a central venous catheter (CVC) are exposed to several risks, being a catheter-related infection (CRI) and a CVC lumen thrombosis among the most serious. Standard of care regarding CVCs includes their sealing with heparin lock solutions to prevent catheter lumen thrombosis. Other lock solutions to prevent CRI, such as antimicrobial lock solutions, have proven useful with antibiotics solutions, but not as yet for non-antibiotic antimicrobial solutions...
April 3, 2018: Cochrane Database of Systematic Reviews
Siri Tribler, Christopher F Brandt, Anne H Petersen, Jørgen H Petersen, Kristian A Fuglsang, Michael Staun, Per Broebech, Claus E Moser, Palle B Jeppesen
Background: In patients with intestinal failure who are receiving home parenteral support (HPS), catheter-related bloodstream infections (CRBSIs) inflict health impairment and high costs. Objective: This study investigates the efficacy and safety of the antimicrobial catheter lock solution, taurolidine-citrate-heparin, compared with heparin 100 IE/mL on CRBSI occurrence. Design: Forty-one high-risk patients receiving HPS followed in a tertiary HPS unit were randomly assigned in a double-blinded, placebo-controlled trial...
September 2017: American Journal of Clinical Nutrition
LeAnn B Norris, Farah Kablaoui, Maggie K Brilhart, P Brandon Bookstaver
BACKGROUND: Central venous catheter (CVC) use is commonplace in cancer patients. Antimicrobial lock therapy (ALT), the instillation of a concentrated antimicrobial solution into the catheter lumen, is one method for preventing infection among CVCs. This systematic review discusses the effectiveness and safety of prophylactic ALT in cancer patients with CVCs. METHODS: A literature search was performed using the Medline database and Google Scholar from inception until April 2016...
September 2017: International Journal of Antimicrobial Agents
Megan K Luther, Leonard A Mermel, Kerry L LaPlante
PURPOSE: The activity of linezolid and vancomycin lock solutions against biofilm-producing strains of Staphylococcus aureus, S. epidermidis, and Enterococcus faecalis was studied. METHODS: Two strains each of methicillin-susceptible S. aureus (MSSA), methicillin-resistant S. aureus (MRSA), and S. epidermidis, and 1 strain of vancomycin-susceptible E. faecalis and vancomycin-resistant E. faecalis were tested against vancomycin and linezolid to assess prevention of biofilm formation and eradication of these pathogens within a formed biofilm...
May 1, 2017: American Journal of Health-system Pharmacy: AJHP
Franklin Correa Barcellos, Bruno Pereira Nunes, Luciana Jorge Valle, Thiago Lopes, Bianca Orlando, Cintia Scherer, Marcia Nunes, Gabriela Araújo Duarte, Maristela Böhlke
BACKGROUND: Central venous catheters (CVC) are the only option when hemodialysis is needed for patients without definitive vascular access. However, CVC is associated with complications, such as infection, thrombosis, and dysfunction, leading to higher mortality and expenditures. The aim of this study was to compare the effectiveness of 30 % trisodium citrate (TSC30 %) with heparin as CVC lock solutions in preventing catheter-related bloodstream infections (CRBSI) and dysfunction in hemodialysis patients...
April 2017: Infection
Issam Raad, Anne-Marie Chaftari, Ramia Zakhour, Mary Jordan, Zanaib Al Hamal, Ying Jiang, Ammar Yousif, Kumait Garoge, Victor Mulanovich, George M Viola, Soha Kanj, Egbert Pravinkumar, Joel Rosenblatt, Ray Hachem
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 vitro and 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 catheter in 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...
June 2016: Antimicrobial Agents and Chemotherapy
Nai Ming Lai, Nathorn Chaiyakunapruk, Nai An Lai, Elizabeth O'Riordan, Wilson Shu Cheng Pau, Sanjay Saint
BACKGROUND: The central venous catheter (CVC) is essential in managing acutely ill patients in hospitals. Bloodstream infection is a major complication in patients with a CVC. Several infection control measures have been developed to reduce bloodstream infections, one of which is impregnation of CVCs with various forms of antimicrobials (either with an antiseptic or with antibiotics). This review was originally published in June 2013 and updated in 2016. OBJECTIVES: Our main objective was to assess the effectiveness of antimicrobial impregnation, coating or bonding on CVCs in reducing clinically-diagnosed sepsis, catheter-related blood stream infection (CRBSI), all-cause mortality, catheter colonization and other catheter-related infections in adult participants who required central venous catheterization, along with their safety and cost effectiveness where data were available...
March 16, 2016: Cochrane Database of Systematic Reviews
Jacqueline E Taylor, Kenneth Tan, Nai Ming Lai, Susan J McDonald
BACKGROUND: Use of a central venous catheter (CVC) in neonates is associated with an increase in nosocomial infection. Numerous strategies exist to prevent catheter-related bloodstream infection (CRBSI); however, CRBSI continues to be a major problem. Antibiotic locking catheters is a new and promising treatment that potentially prevents this severe condition. OBJECTIVES: To assess the effectiveness of antibiotic lock versus no antibiotic lock or alternative antibiotic lock in the prevention of catheter-related infections in newborn infants of any gestational age during their initial stay in the neonatal unit and to study any relevant adverse effects from antibiotic lock therapy...
2015: Cochrane Database of Systematic Reviews
Alexa Grudzinski, Arnav Agarwal, Neera Bhatnagar, Gihad Nesrallah
BACKGROUND: Citrate has theoretical advantages over heparin for locking hemodialysis central venous catheters (CVCs), but the comparative effectiveness of these agents is not clear. OBJECTIVES: 1) To compare the benefits and harms of citrate versus heparin locking solutions among patients undergoing hemodialysis through CVCs; 2) to appraise methodological quality of the supporting evidence. DATA SOURCES: CENTRAL, MEDLINE, EMBASE, CINAHL, ISI Web of Science, and nephrology conference abstracts...
2015: Canadian Journal of Kidney Health and Disease
Alexander Schweiger, Sergio Trevino, Jonas Marschall
Nosocomial infections in patients requiring renal replacement therapy have a high impact on morbidity and mortality. The most dangerous complication is bloodstream infection (BSI) associated with the vascular access, with a low BSI risk in arteriovenous fistulas or grafts and a comparatively high risk in central venous catheters. The single most important measure for preventing BSI is therefore the reduction of catheter use by means of early fistula formation. As this is not always feasible, prevention should focus on educational efforts, hand hygiene, surveillance of dialysis-associated events, and specific measures at and after the insertion of catheters...
2015: Contributions to Nephrology
Macarena Jiménez, Trinidad Madrid
Central venous catheter-related blood stream infection is a major cause of morbidity and mortality in patients with renal disease treated with hemodialysis. Antibiotic lock solutions can be effective in preventing this complication in patients with hemodialysis. Searching in Epistemonikos database, which is maintained by screening more than twenty databases, we identified eight systematic reviews including seventeen randomized trials. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach...
January 22, 2015: Medwave
Bindu A Passero, Paula Zappone, Herma E Lee, Cindy Novak, Erica L Maceira, Martha Naber
INTRODUCTION: There is a paucity of medical literature regarding the efficacy of lock solutions in preventing catheter thrombosis. Traditionally, heparin has been used as the anticoagulant of choice for catheter locking, but it has many adverse effects associated with its use. Sodium citrate 4% is an attractive alternative to heparin. METHODS: Our plasmapheresis unit converted to locking all central venous catheters with sodium citrate 4% in place of heparin 100 units/mL in May 2010...
February 2015: Journal of Clinical Apheresis
Megan K Luther, Leonard A Mermel, Kerry L LaPlante
OBJECTIVES: Antimicrobial lock solutions are used for prevention and management of catheter-related bloodstream infections. ML8-X10 (a prototype oil-in-water micro-emulsion based on a novel free fatty acid), vancomycin/heparin and taurolidine/citrate/heparin (Taurolock™-Hep500) lock solutions were tested against biofilm-forming Staphylococcus epidermidis and methicillin-susceptible Staphylococcus aureus. METHODS: MICs were tested in neutral broth (pH ~7) and acidified broth (pH 5)...
December 2014: Journal of Antimicrobial Chemotherapy
R S Boersma, K S Jie, A C Voogd, K Hamulyak, A Verbon, H C Schouten
PURPOSE AND METHODS: Central venous catheter (CVC)-related thrombosis and infections are frequently occurring complications in patients with hematological malignancies. At present, heparin is most often used as a locking solution. Trisodium citrate (TSC) had been shown to be a very effective antimicrobial catheter locking in hemodialysis patients. We performed a prospective randomized phase III multicenter trial to determine the efficacy of TSC as a locking solution compared to heparin in preventing CVC-related thrombosis and infections in patients with hematological malignancies...
January 2015: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
E C Murray, C Deighan, C Geddes, P C Thomson
BACKGROUND: Infection is second only to cardiovascular disease as a cause of death in the haemodialysis (HD) population. AIM: : To assess the effect of introducing catheter lock solution taurolidine-citrate-heparin to all tunnelled central venous catheters (TCVCs) on staphylococcal bloodstream infection rates in patients on chronic HD. DESIGN: Observational, prospective analysis of the incidence rates of staphylococcal bacteraemic events in National Health Service (NHS) Greater Glasgow & Clyde and NHS Forth Valley between April 2011 and June 2013, with taurolidine-citrate-heparin catheter lock solution introduced July 2012...
December 2014: QJM: Monthly Journal of the Association of Physicians
Melanie Keeler
More than 800 blood cell and bone marrow transplants are performed annually in Canada to treat fatal cancers and rare blood disorders. Central vascular access is fundamental in blood and marrow transplant nursing to facilitate chemotherapy and blood product infusions. A tunnelled Central Venous Catheter (CVC) is the vascular access device-of-choice in the cell and marrow transplant population. Several practice guidelines direct nursing policy and procedure for CVC management and care. CVC insertion and removal guidelines are increasingly relevant given the widening scope of advanced practice nursing...
2014: Canadian Oncology Nursing Journal, Revue Canadienne de Nursing Oncologique
Maurizio Gallieni, Irene Brenna, Francesca Brunini, Nicoletta Mezzina, Sabina Pasho, Antonino Giordano
The choice of both short-term (nontunneled) and long-term (tunneled) central venous catheters (CVCs) for hemodialysis is a difficult one, due to the large number of available catheters, with very different characteristics and cost.CVC-related complications (in particular infections, thrombosis and inefficient dialysis) can determine ominous consequences and death, with extremely elevated costs due to prolonged hospitalization and expensive procedures. Thus, the correct balance between cost and quality of CVC is required when deciding which kind of CVC should be adopted...
2014: Journal of Vascular Access
Alberto Dal Molin, Elias Allara, Doriana Montani, Simona Milani, Cristina Frassati, Simonetta Cossu, Simone Tonella, Dania Brioschi, Laura Rasero
PURPOSE: The aim of this systematic review was to assess the efficacy of heparin flushing in the lock of central venous catheters. METHODS: We searched MEDLINE and CINAHL databases. Eligible studies were randomized controlled trials evaluating the use of heparin versus normal saline or other solution in the flushing of central catheter among adult patients. No language restrictions were applied. Two reviewers independently screened titles and abstracts in order to identify relevant publications...
July 2014: Journal of Vascular Access
Elisabetta Dioni, Renata Franceschini, Roberto Marzollo, Daniela Oprandi, Gaetano Chirico
Newborn infants in critical conditions require a permanent intra-venous line to allow for the administration of fluids, parenteral nutrition and drugs. The use of central venous catheters, however, is associated with an increased risk of infections, leading to prolongation of length of stay and higher hospitalization costs, particularly in extremely preterm infants. Dwell time is a significant factor for complications, with a predicted risk of catheter related infections of about 4 per 1000 catheter-days. To reduce the incidence of complications, several requirements must be met, including adequate staff and resources to provide education, training, and quality improvement programs, within a culture of communication and teamwork...
March 2014: Early Human Development
Jyotsna Chandra, Eric Pearlman, Mahmoud A Ghannoum
Microbial biofilms play an essential role in several infectious diseases and are defined as extensive communities of sessile organisms irreversibly associated with a surface, encased within a polysaccharide-rich extracellular matrix (ECM), and exhibiting enhanced resistance to antimicrobial drugs. Forming a biofilm provides the microbes protection from environmental stresses due to contaminants, nutritional depletion, or imbalances, but is dangerous to human health due to their inherent robustness and elevated resistance...
2014: Methods in Molecular Biology
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