Adjunctive antibiotic/anticoagulant lock therapy in the treatment of bacteremia associated with the use of a subcutaneously implanted hemodialysis access device
| Autor: | Joseph Megerman, R Boorgu, David A. Hatch, Nathan W. Levin, H My, Bernard Canaud, T S Ing, J R Lentino, Frank R. Prosl, Alan Dubrow, D W Wentworth, Vasant C. Gandhi |
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| Rok vydání: | 2000 |
| Předmět: |
medicine.medical_specialty
Percutaneous medicine.drug_class medicine.medical_treatment Antibiotics Biomedical Engineering Biophysics Bioengineering Bacteremia Pilot Projects Biomaterials Catheters Indwelling Renal Dialysis medicine Humans Antibacterial agent business.industry Anticoagulant Anticoagulants General Medicine medicine.disease Surgery Anti-Bacterial Agents Catheter Anesthesia Hemodialysis Complication business |
| Zdroj: | ASAIO journal (American Society for Artificial Internal Organs : 1992). 46(6) |
| ISSN: | 1058-2916 |
| Popis: | To improve vascular access for hemodialysis, a new device (Dialock Hemodialysis Access System, Biolink Corporation, Middleboro, MA) has been developed. Implanted subcutaneously, the device is accessed by percutaneous puncture. Attached to the device are two catheters that are implanted into the superior vena cava or right atrium. Clinical results thus far have been promising. However, use of this device is not free from infectious complications. In the present pilot study, 25 maintenance hemodialysis patients were implanted with 26 Dialock devices. The incidence of bacteremia was 2.9/1,000 catheter days. In 14 episodes of bacteremia in 8 patients the infection was successfully treated with a combination of systemic antibiotic treatment and adjunctive antibiotic/anticoagulant lock therapy. The lock therapy entailed the instillation of both an antibiotic and an anticoagulant into the device. We believe that the antibiotic/anticoagulant lock technique is an effective, adjunctive therapeutic modality in the treatment of infections related to the use of indwelling vascular access devices. |
| Databáze: | OpenAIRE |
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