Effects of Prolonged Ethanol Lock Exposure to Carbothane- and Silicone-based Hemodialysis Catheters: A 26-week Study
| Autor: | Gregory Braden, Daniel Landry, George S. Lipkowitz, Michael H. O'Shea, Adam P. Hathorne, Harry Bermudez, Randa A Jaber, Nandheesha Hanumanthappa |
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| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Time Factors medicine.medical_treatment Silicones Hemodialysis Catheter Prosthesis Design Heparin lock chemistry.chemical_compound Catheters Indwelling Silicone Renal Dialysis Elastic Modulus Materials Testing medicine Ethanol lock Chronic hemodialysis Dialysis Ethanol Heparin business.industry Anticoagulants Anti-Bacterial Agents Prosthesis Failure Surgery Equipment Failure Analysis Catheter chemistry Nephrology Catheter-Related Infections Anesthesia Anti-Infective Agents Local Stress Mechanical Hemodialysis business Vascular Access Devices |
| Zdroj: | The Journal of Vascular Access. 16:367-371 |
| ISSN: | 1724-6032 1129-7298 |
| Popis: | Purpose Antibiotic locks in catheter-dependent chronic hemodialysis patients reduce the rate of catheter-related bloodstream infections (CRBSIs), but may be associated with the development of resistant bacteria. Ethanol-based catheter locks may provide a better alternative; however, there are limited data on the long-term integrity of dialysis catheters exposed to ethanol. Methods We performed in vitro testing of two types of hemodialysis catheters—silicone (SLC) and carbothane (CBT) based—with a 70% ethanol lock (EL) versus heparin lock (HL) for 26 weeks. Lock solutions were changed thrice weekly to mimic a conventional hemodialysis schedule. We tested mechanical properties of the catheters at 0, 13 and 26 weeks by examining stress/strain relationships (SS400%) and modulus of elasticity (ME). Electron microscopy was performed to examine catheter ultrastructure at 0 and 26 weeks. Results Catheter integrity for HL versus EL in SLC (SS400%: 4.5 vs. 4.5 MPa, p = NS; ME: 4.6 vs. 4.7 MPa, p = NS) or CBT-based catheters (SS400%: 7.6 vs. 8.9 MPa, p = NS; ME: 9.6 vs. 12.2 MPa, p = NS) were all similar at 13 and 26 weeks. Scanning electron microscopy revealed no structural changes in the central and luminal wall internal surfaces of EL- versus HL-treated catheters. Conclusions There were no significant differences in catheter integrity between SLC or CBT catheters exposed to a 70% EL for 26 weeks. Given its low cost, potential to avoid antibiotic resistance and structural integrity after 6 months of high-dose ethanol, ELs should be studied prospectively against antibiotic locks to assess the efficacy and safety in hemodialysis patients. |
| Databáze: | OpenAIRE |
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