A novel antimicrobial and antithrombotic lock solution for hemodialysis catheters: A multi-center, controlled, randomized trial*

Maki, Dennis G.; Ash, Stephen R.; Winger, Roland K.; Lavin, Philip T.

doi:10.1097/ccm.0b013e318206b5a2

Cited by 107 publications

(84 citation statements)

References 35 publications

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“…Because more recent studies using bundled care without antimicrobial locks have achieved CRBSI rates of #1 per 1000 catheter-days, can the use of antimicrobial locks further reduce CRBSI? Abbas et al performed an observational study of gentamicin-heparin versus heparin catheter locks, while Maki and Moran and their colleagues performed randomized controlled trials with gentamicin-trisodium citrate (citrate) and citratemethylene blue-methylparaben-propylparaben, respectively (17)(18)(19). All three studies achieved CRBSI rates of ,1 per 1000 catheter-days in their control groups and yet still showed a significant decrease in infection rates with their interventions (Abbas, Moran, and Maki et al reported rates of 0.62, 0.28, and 0.24 events per 1000 catheter-days, respectively).…”

mentioning

confidence: 99%

Reducing Catheter-Related Infections in Hemodialysis Patients

Landry

Braden

2014

Clinical Journal of the American Society of Nephrology

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mentioning

confidence: 99%

Reducing Catheter-Related Infections in Hemodialysis Patients

Landry

Braden

2014

Clinical Journal of the American Society of Nephrology

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“…Other lock solutions with antimicrobial properties, such as citrate-and taurolidine-containing locks have showed mixed results regarding the impact on CLABSI incidence in dialysis patients. A novel catheter lock solution containing 7.0% sodium citrate, 0.15% methylene blue, 0.15% methylparaben, and 0.015% propylparaben (C-MB-P) was superior to standard heparin lock in a randomized controlled trial of 407 HD patients [24] . Thrombolytic locking solution has also shown promise in reducing bacteremias.…”

Section: Antimicrobial Lock Solutionsmentioning

confidence: 99%

Nosocomial Infections in Dialysis Access

Schweiger

Trevino²,

Marschall³

2015

Contributions to Nephrology

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Nosocomial infections in patients requiring renal replacement therapy have a high impact on morbidity and mortality. The most dangerous complication is bloodstream infection (BSI) associated with the vascular access, with a low BSI risk in arteriovenous fistulas or grafts and a comparatively high risk in central venous catheters. The single most important measure for preventing BSI is therefore the reduction of catheter use by means of early fistula formation. As this is not always feasible, prevention should focus on educational efforts, hand hygiene, surveillance of dialysis-associated events, and specific measures at and after the insertion of catheters. Core measures at the time of insertion include choosing the optimal site of insertion, the use of maximum sterile barrier precautions, adequate skin antisepsis, and the choice of catheter type; after insertion, access care needs to ensure hub disinfection and regular dressing changes. The application of antimicrobial locks is reserved for special situations. Evidence suggests that bundling a selection of the aforementioned measures can significantly reduce infection rates. The diagnosis of central lineassociated BSI (CLABSI) is based on clinical signs and microbiological findings in blood cultures ideally drawn both peripherally and from the catheter. The prompt installation of empiric antibiotic treatment covering the most commonly encountered organisms is key regarding CLABSI treatment. Catheter removal is recommended in complicated cases or if cultures yield Staphylococcus aureus , enterococci, Pseudomonas or fungi. In other cases, guide wire exchange or catheter salvage strategies with antibiotic lock solutions may be acceptable alternatives.

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“…Maki et al 23 have described a multicenter study in which a solution containing 0.24 M (7.0%) sodium citrate, 0.15% methylene blue, 0.15% methylparaben and 0.015% propylparaben (C-MB-P) was compared with heparin, reporting a significant reduction in…”

Section: Central Venous Cathetersmentioning

confidence: 99%

Acesso vascular para hemodialise: o que ha de novo?

et al. 2013

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The increasing life expectancy of patients with chronic diseases, including chronic renal failure, means that treatment methods are constantly being updated and improved. Long term hemodialysis has created the need to provide and maintain long lasting vascular access. Arteriovenous fistula is the first-choice option for hemodialysis and research has been conducted to attempt to increase the useful life of both fistula and catheter access methods. This article reviews the vascular access options and solutions currently available for hemodialysis.Keywords: renal dialysis; catheters; arteriovenous fistula. ResumoO aumento da expectativa de vida dos portadores de doenças crônicas, entre as quais a insuficiência renal crônica, faz com que métodos de tratamentos estejam em constante aperfeiçoamento. O uso em longo prazo da hemodiálise torna necessário confeccionar e manter acessos vasculares de utilização duradoura. Tanto as fístulas arteriovenosas -primeira opção de acesso para os pacientes hemodialíticos -como os cateteres vêm sendo objeto de estudos na literatura, na tentativa de prolongar sua vida útil. Esta revisão tem como objetivo relatar as alternativas e soluções atuais para os acessos vasculares para hemodiálise.Palavras-chave: diálise renal; cateteres; fístula arteriovenosa.

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A novel antimicrobial and antithrombotic lock solution for hemodialysis catheters: A multi-center, controlled, randomized trial*

Abstract: The novel C-MB-P lock solution is well tolerated, significantly reduces the risk of catheter-related bloodstream infection, and provides protection comparable to heparin against patency failure.

Cited by 107 publications

References 35 publications

Reducing Catheter-Related Infections in Hemodialysis Patients

Reducing Catheter-Related Infections in Hemodialysis Patients

Nosocomial Infections in Dialysis Access

Acesso vascular para hemodialise: o que ha de novo?

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