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A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit
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Prevention of hemodialysis catheter-related bloodstream infection using an antimicrobial lock

Francesco Quarello1, Giacomo Forneris

  • 1Nephrology and Dialysis Unit, San Giovanni Bosco Hospital, Turin, Italy. fquarello@tin.it

Blood Purification
|January 23, 2002
PubMed

Insights

Totally implanted devices and taurolidine lock solutions show promise in reducing hemodialysis catheter infections. These innovations may improve vascular access reliability and patient outcomes by decreasing infection episodes.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Biomaterials

Background:

  • Central venous catheters used for hemodialysis have significant limitations, including thrombosis, stenosis, and catheter-related bloodstream infections (CRBI).
  • CRBI necessitates catheter removal and prolonged antibiotic treatment, impacting patient health and healthcare costs.

Purpose of the Study:

  • To evaluate the efficacy of a totally implanted vascular access device (Dialock) in reducing catheter-related infections compared to standard tunneled catheters.
  • To assess the impact of a taurolidine-based lock solution (Neutrolin) on CRBI rates in patients undergoing hemodialysis.

Main Methods:

  • A comparative study assessed infection rates between totally implanted devices and tunneled catheters.
  • A separate study investigated the reduction in CRBI using a taurolidine-based lock solution with different catheter types.

Main Results:

  • The totally implanted device demonstrated a significant reduction in overall catheter-related infections (0.97 vs. 4.75 episodes/1,000 catheter-days), primarily due to fewer local cutaneous infections.
  • Bloodstream infection rates were similar between the totally implanted device and tunneled catheters.
  • The taurolidine-based lock solution significantly decreased CRBI rates to 0.29 and 0.20 episodes/1,000 catheter-days for subcutaneous ports and tunneled catheters, respectively.

Conclusions:

  • Totally implanted vascular access devices may offer improved protection against local catheter-related infections.
  • Taurolidine-based lock solutions show significant potential in reducing CRBI during hemodialysis.
  • Further clinical trials are needed to confirm these promising findings for vascular access management.

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