View in EDS

Observational Study of Need for Thrombolytic Therapy and Incidence of Bacteremia using Taurolidine‐Citrate‐Heparin, Taurolidine‐Citrate and Heparin Catheter Locks in Patients Treated with Hemodialysis

Saved in:
Bibliographic Details
Title: Observational Study of Need for Thrombolytic Therapy and Incidence of Bacteremia using Taurolidine‐Citrate‐Heparin, Taurolidine‐Citrate and Heparin Catheter Locks in Patients Treated with Hemodialysis
Authors: Solomon, Laurie R, Cheesbrough, John S, Bhargava, Ramya, Mitsides, Nicos, Heap, Michael, Green, Gerwyn, Diggle, Peter
Source: Solomon, L R, Cheesbrough, J S, Bhargava, R, Mitsides, N, Heap, M, Green, G & Diggle, P 2011, 'Observational study of need for thrombolytic therapy and incidence of bacteremia using taurolidine-citrate-heparin, taurolidine-citrate and heparin catheter locks in patients treated with hemodialysis', Seminars in Dialysis, vol. 25, no. 2, pp. 233-8. https://doi.org/10.1111/j.1525-139X.2011.00951.x
Publisher Information: Wiley, 2011.
Publication Year: 2011
Subject Terms: Thiadiazines/therapeutic use, Adult, Male, Catheters, Anti-Infective Agents/therapeutic use, Bacteremia, Chronic/diagnosis, Kaplan-Meier Estimate, Risk Assessment, Citric Acid, Taurine/analogs & derivatives, Kidney Failure, Catheter-Related Infections/drug therapy, 03 medical and health sciences, Renal Dialysis/adverse effects, Catheters, Indwelling, 0302 clinical medicine, Drug Therapy, Thrombolytic Therapy/methods, Anti-Infective Agents, Double-Blind Method, Bacteremia/drug therapy, Indwelling/adverse effects, Vascular Patency/physiology, Humans, Catheters, Indwelling/adverse effects, Heparin/therapeutic use, Proportional Hazards Models, Aged, Equipment Contamination/prevention & control, Heparin, Citric Acid/therapeutic use, Incidence, Anticoagulants, Middle Aged, Kidney Failure, Chronic/diagnosis, 3. Good health, Treatment Outcome, Anticoagulants/therapeutic use, Catheter-Related Infections, Combination, Linear Models, Equipment Contamination, Kidney Failure, Chronic, Drug Therapy, Combination, Female, Needs Assessment, Follow-Up Studies
Description: Catheter‐related blood stream infections may be reduced by interdialytic locking with Taurolidine, a nontoxic antimicrobial agent. A formulation of 1.35% Taurolidine in 4% citrate (TC) is associated with a greater need for thrombolysis to maintain catheter patency than 5000 U/ml heparin. Our aim was to determine whether addition of 500 Units/ml of heparin to TC reduces the need for thrombolysis. TCH (1.35% taurolidine, 4% citrate and 500 U/ml heparin) was compared to TC and Heparin 5000 U/ml using retrospective data. Hundred and six adult hemodialysis patients with internal jugular tunnelled intravascular catheters using TCH were compared with 34 patients using TC and 34 patients using heparin 5000 U/ml respectively. Outcomes were time to first use of thrombolysis and bacteremia rates.TCH reduced the need for thrombolysis compared to TC (hazard ratio, 0.2; 95%CI: 0.06, 0.5; p ) and was not significantly different from heparin 5000 U/ml (hazard ratio, 1.4; 95%CI: 0.5, 3.9; p = 0.5). The bacteremia rates from all causes were 1.33, 1.22 and 3.25 per 1000 catheter‐ days (p ) in the TCH, TC and heparin groups respectively. Addition of 500 U/ml heparin to TC reduces the need for thrombolysis without increasing bacteremia and may achieve patency comparable to heparin 5000 U/ml.
Document Type: Article
Language: English
ISSN: 1525-139X
0894-0959
DOI: 10.1111/j.1525-139x.2011.00951.x
Access URL: https://pubmed.ncbi.nlm.nih.gov/21916999
https://research.manchester.ac.uk/en/publications/de99222e-ee3f-4539-9d7d-5033c36e405e
https://doi.org/10.1111/j.1525-139X.2011.00951.x
https://pubmed.ncbi.nlm.nih.gov/21916999/
https://europepmc.org/article/MED/21916999
https://www.ncbi.nlm.nih.gov/pubmed/21916999
https://www.research.manchester.ac.uk/portal/en/publications/observational-study-of-need-for-thrombolytic-therapy-and-incidence-of-bacteremia-using-taurolidinecitrateheparin-taurolidinecitrate-and-heparin-catheter-locks-in-patients-treated-with-hemodialysis(de99222e-ee3f-4539-9d7d-5033c36e405e).html
https://onlinelibrary.wiley.com/doi/10.1111/j.1525-139X.2011.00951.x
https://jhu.pure.elsevier.com/en/publications/observational-study-of-need-for-thrombolytic-therapy-and-incidenc-5
Rights: Wiley Online Library User Agreement
Accession Number: edsair.doi.dedup.....913526b7aaebd5c8dc76c56c83c221b4
Database: OpenAIRE
Description
Abstract:Catheter‐related blood stream infections may be reduced by interdialytic locking with Taurolidine, a nontoxic antimicrobial agent. A formulation of 1.35% Taurolidine in 4% citrate (TC) is associated with a greater need for thrombolysis to maintain catheter patency than 5000 U/ml heparin. Our aim was to determine whether addition of 500 Units/ml of heparin to TC reduces the need for thrombolysis. TCH (1.35% taurolidine, 4% citrate and 500 U/ml heparin) was compared to TC and Heparin 5000 U/ml using retrospective data. Hundred and six adult hemodialysis patients with internal jugular tunnelled intravascular catheters using TCH were compared with 34 patients using TC and 34 patients using heparin 5000 U/ml respectively. Outcomes were time to first use of thrombolysis and bacteremia rates.TCH reduced the need for thrombolysis compared to TC (hazard ratio, 0.2; 95%CI: 0.06, 0.5; p ) and was not significantly different from heparin 5000 U/ml (hazard ratio, 1.4; 95%CI: 0.5, 3.9; p = 0.5). The bacteremia rates from all causes were 1.33, 1.22 and 3.25 per 1000 catheter‐ days (p ) in the TCH, TC and heparin groups respectively. Addition of 500 U/ml heparin to TC reduces the need for thrombolysis without increasing bacteremia and may achieve patency comparable to heparin 5000 U/ml.
ISSN:1525139X
08940959
DOI:10.1111/j.1525-139x.2011.00951.x