Hemodialysis catheter heparin lock related bleeding: Hemorrhagic shock every other day

2021 ◽  
pp. 112972982199397 ◽  
Author(s):  
Joana Marques ◽  
Tiago Isidoro Duarte ◽  
Patrícia Cotovio ◽  
André Borges ◽  
Nuno Germano
Keyword(s):  
Hemorrhagic Shock ◽  
Sodium Citrate ◽  
Minimal Risk ◽  
Bleeding Events ◽  
Hemodialysis Catheter ◽  
Catheter Dysfunction ◽  
Catheter Patency ◽  
Catheter Lock ◽  
Systemic Anticoagulation ◽  
Heparin Lock

Catheter dysfunction is an important cause of catheter loss. In order to prevent this, locking solutions with minimal risk of systemic anticoagulation are used to ensure catheter patency. At present the most commonly used solutions are either heparin or sodium citrate. According to the literature use of sodium citrate may be advantageous in reducing bleeding events. We report a case of hemorrhagic shock following hemodialysis catheter lock with heparin, reversed after switching solution to sodium citrate.

scholarly journals Minimizing Hemodialysis Catheter Dysfunction: An Ounce of Prevention

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Timmy Lee ◽  
Charmaine Lok ◽  
Miguel Vazquez ◽  
Louise Moist ◽  
Ivan Maya ◽  
...  
Keyword(s):  
Sodium Citrate ◽  
Oral Anticoagulants ◽  
Antiplatelet Agents ◽  
Prophylactic Regimen ◽  
Hemodialysis Catheter ◽  
Tissue Plasminogen ◽  
Catheter Lock ◽  
Tunneled Catheter ◽  
Heparin Lock

The maintenance of tunneled catheter (TC) patency is critical for the provision of adequate hemodialysis in patients who are TC-dependent. TC dysfunction results in the need for costly and inconvenient interventions, and reduced quality of life. Since the introduction of TCs in the late 1980s, heparin catheter lock has been the standard prophylactic regimen for the prevention of TC dysfunction. More recently, alternative catheter locking agents have emerged, and in some cases have shown to be superior to heparin lock with respect to improving TC patency and reducing TC-associated infections. These include citrate, tissue plasminogen activator, and a novel agent containing sodium citrate, methylene blue, methylparaben, and propylparaben. In addition, prophylaxis using oral anticoagulants/antiplatelet agents, including warfarin, aspirin, ticlodipine, as well as the use of modified heparin-coated catheters have also been studied for the prevention of TC dysfunction with variable results. The use of oral anticoagulants and/or antiplatelet agents as primary or secondary prevention of TC dysfunction must be weighed against their potential adverse effects, and should be individualized for each patient.

A 2% taurolidine catheter lock solution prevents catheter-related bloodstream infection (CRBSI) and catheter dysfunction in hemodialysis patients

2021 ◽  
Vol 30 (14) ◽  
pp. S24-S32
Author(s):  
Matthias Alexander Neusser ◽  
Irina Bobe ◽  
Anne Hammermeister ◽  
Udo Wittmann
Keyword(s):  
Adverse Events ◽  
Bloodstream Infection ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Technical Problems ◽  
Hemodialysis Catheter ◽  
Catheter Dysfunction ◽  
Lock Solution ◽  
Catheter Lock ◽  
Catheter Related Bloodstream Infection

HIGHLIGHTS 2% taurolidine catheter lock solution without additives is safe and efficient. CRBSI and dysfunction rates compare favorably against other studies in hemodialysis Background: In hemodialysis patients, catheter-related bloodstream infection (CRBSI) and catheter dysfunction are common and cause significant morbidity, mortality, and costs. Catheter lock solutions reduce CRBSI and catheter dysfunction rates, but solutions containing heparin, citrate, or antibiotics are associated with adverse effects. Due to its antimicrobial and antithrombotic properties and benign safety profile, taurolidine is suitable for use in catheter lock solutions. In this study the effectiveness and safety of a catheter lock solution containing 2% taurolidine without citrate or heparin (TauroSept®, Geistlich Pharma AG, Wolhusen, Switzerland) in hemodialysis patients were investigated for the first time. Methods: Data from 21 patients receiving chronic hemodialysis via tunneled central venous catheters with 2% taurolidine solution as a catheter lock were analyzed in a single-center retrospective study and compared with the existing literature in a review. The primary endpoint was CRBSI rate. Secondary endpoints included catheter dysfunction, treatment, and costs; catheter technical problems, resolution, and costs; and adverse events. Data were compared to outcomes with standard lock solutions in the literature. Results: No CRBSIs occurred during the observation period of 5,639 catheter days. The catheter dysfunction rate was 0.71 per 1,000 catheter days, and the catheter dysfunction treatment costs were CHF (Swiss Franc) 543 per patient. No technical problems or adverse events related to the use of 2% taurolidine-containing catheter lock solution were observed. These results compare favorably with other catheter lock solutions. Conclusions: A solution containing 2% taurolidine seems suitable as a hemodialysis catheter lock. In a Swiss cohort, it prevented CRBSI, limited catheter dysfunction, and was cost-efficient.

Concentrated Heparin Lock Is Associated with Major Bleeding Complications after Tunneled Hemodialysis Catheter Placement

2007 ◽  
Vol 20 (4) ◽  
pp. 351-354 ◽  
Author(s):  
Alexander S. Yevzlin ◽  
Robert J. Sanchez ◽  
Jeanne G. Hiatt ◽  
Marilyn H. Washington ◽  
Maureen Wakeen ◽  
...  
Keyword(s):  
Major Bleeding ◽  
Catheter Placement ◽  
Bleeding Complications ◽  
Hemodialysis Catheter ◽  
Heparin Lock

Efficacy of 1.4 Percent Sodium Citrate in Maintaining Arterial Catheter Patency in Patients in a Medical ICU

CHEST Journal ◽  
1993 ◽  
Vol 103 (3) ◽  
pp. 882-885 ◽  
Author(s):  
Pamela K. Branson ◽  
Randall A. McCoy ◽  
Barbara A. Phillips ◽  
G. Dennis Clifton
Keyword(s):  
Sodium Citrate ◽  
Arterial Catheter ◽  
Catheter Patency

A 2% Taurolidine Catheter Lock Solution Prevents Catheter-Related Bloodstream Infection (CRBSI) and Catheter Dysfunction in Hemodialysis Patients

2020 ◽  
Vol 25 (4) ◽  
pp. 48-56
Author(s):  
Matthias Alexander Neusser ◽  
Irina Bobe ◽  
Anne Hammermeister ◽  
Udo Wittmann
Keyword(s):  
Bloodstream Infection ◽  
Hemodialysis Patients ◽  
Catheter Dysfunction ◽  
Lock Solution ◽  
Catheter Lock ◽  
Catheter Related Bloodstream Infection

Highlights 2% Taurolidine catheter lock solution without additives is safe and efficient. CRBSI and dysfunction rates compare favorably against other studies in hemodialysis.

scholarly journals Tissue plasminogen activator infusion as a treatment for hemodialysis catheter dysfunction

2010 ◽  
Vol 39 (3) ◽  
pp. 97-99 ◽  
Author(s):  
Aekarach Ariyachaipanich ◽  
Olatokunbo Oyejola ◽  
Arafat Melhem ◽  
Vinaya Soundararajan ◽  
Edgar Lerma ◽  
...  
Keyword(s):  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Hemodialysis Catheter ◽  
Catheter Dysfunction ◽  
Tissue Plasminogen
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