The best solution down the line: an observational study on taurolidine- versus citrate-based lock solutions for central venous catheters in hemodialysis patients
| Autor: | Roeden, S. van, Oevelen, M. van, Abrahams, A.C., Dekker, F.W., Rotmans, J.I., Meijvis, S.C.A., DUCATHO Study Grp |
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| Přispěvatelé: | Internal Medicine |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Record locking Taurine medicine.medical_treatment Lock solution Citric Acid chemistry.chemical_compound Catheters Indwelling Internal medicine medicine Central Venous Catheters Humans Aged Retrospective Studies Lock Thiadiazines business.industry Heparin Research Hazard ratio Anticoagulants Taurolidine Middle Aged medicine.disease Thrombosis Diseases of the genitourinary system. Urology Catheter chemistry Nephrology Anesthesia Hemodialysis Catheter-Related Infections Observational study Equipment Failure Female RC870-923 business Central venous catheter |
| Zdroj: | BMC Nephrology BMC Nephrology, 22(1). BMC BMC Nephrology, Vol 22, Iss 1, Pp 1-8 (2021) BMC Nephrology, 22(1):308, 1-8. BioMed Central Ltd. |
| ISSN: | 1471-2369 |
| Popis: | Introduction To prevent infection and thrombosis of central venous catheters (CVCs) in hemodialysis patients, different CVC lock solutions are available. Taurolidine-based solutions and citrate in different concentrations are frequently used, but no definite conclusions with regard to superiority have been drawn. Methods In this retrospective, observational, multicenter study, we aimed to assess the risk for removal of CVC due to infection or catheter malfunction in hemodialysis patients with CVC access for different lock solutions: taurolidine, high-concentrated citrate (46.7%) and low-concentrated citrate (4 or 30%). A multivariable Cox-regression model was used to calculate hazard ratio’s (HR). Results We identified 1514 patients (median age 65 years, 59% male). In 96 (6%) taurolidine-based lock solutions were used. In 1418 (94%) citrate-based lock solutions were used (high-concentrated 73%, low-concentrated 20%). Taurolidine-based lock solutions were associated with a significantly lower hazard for removal of CVC due to infection or malfunction combined (HR 0.34, 95% CI 0.19–0.64), and for removal of CVC due to infection or malfunction separately (HR 0.36, 95% CI 0.15–0.88 and HR0.33, 95% CI 0.14–0.79). High-concentrated citrate lock solutions were not associated with a decreased hazard for our outcomes, compared to low-concentrated citrate lock solutions. Conclusion Removal of CVC due to infection or catheter malfunction occurred less often with taurolidine-based lock solutions. We present the largest cohort comparing taurolidine- and citrate-based lock solutions yet. However, due to the retrospective observational nature of this study, conclusions with regard to superiority should be drawn with caution. |
| Databáze: | OpenAIRE |
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