Catheter lock solution

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Catheter lock solution is a solution put into

citrate (1000 U/mL and 3.5% respectively[1]), two compounds commonly used to prevent thrombosis
and maintain catheter patency. Other brand names include Citra-Lock and Taurolock.

Neutrolin also contains taurolidine, an anti-microbial agent that has been shown to be safe and effective in preventing bacterial colonization of catheters.[2][3][4][5][6] No resistance to taurolidine has been observed to date.

To avoid the use of heparin in central venous catheters, citrate catheter locks were developed. Citrate solutions can be used as a catheter lock without any additives like antibiotic agents or antiseptic agents like taurolidine. Antibiotic catheter lock solutions could lead to antibiotic resistance and taurolidine has been associated with catheter-related clotting. Therefore it is necessary to mix taurolidine products with heparin to avoid catheter patency issues like thrombosis.[7] Heparin is an anticoagulant, and if used as a catheter lock solution it could leak into the blood circulation of the patient. Therefore it has been associated with catheter-related bleeding and heparin induced thrombocytopenia (HIT).[8][9]

Citrate catheter lock solutions are being used in three different concentrations – 4%, 30% and 46.7%. Citrate catheter lock solutions of 4% concentration have been recommended as best practice in a position statement of European Renal Best Practice guidelines, as published in 2010.[10]

The concentrations of 30% citrate and 46.7% citrate used as catheter lock solution have been associated with lower rates of catheter related infection and a decrease of the use of thrombolytic agents like urokinase or tissue plasminogen activator (t-PA).[11][12]

Taurolidine/heparin (Defencath) was approved for medical use in the United States in November 2023.[13][14]

References

  1. ^ Neutrolin Product Brochure Archived 2014-02-02 at the Wayback Machine.
  2. PMID 20207458
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  3. PMID 15519483
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  4. PMID 18664278
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  5. PMID 14993498
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  6. S2CID 39838675.{{cite journal}}: CS1 maint: multiple names: authors list (link
    )
  7. PMID 12802753
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  8. PMID 11572899
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  9. PMID 15855206
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  10. PMID 30792802
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  11. S2CID 914726
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  12. PMID 12454232
    .
  13. ^ "FDA approves new drug under special pathway for patients receiving hemodialysis". U.S. Food and Drug Administration (FDA). 15 November 2023. Archived from the original on 12 December 2023. Retrieved 16 November 2023. Public Domain This article incorporates text from this source, which is in the public domain.
  14. ^ "CorMedix Inc. Announces FDA Approval of Defencath to Reduce the Incidence of Catheter-Related Bloodstream Infections in Adult Hemodialysis Patients" (Press release). Cormedix Inc. 15 November 2023. Retrieved 16 November 2023 – via GlobeNewswire.
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