Temporary hemodialysis; taurolidine lock to prevent catheter-related blood stream infections

ABSTRACT

Catheter related blood stream infections [CRBSI] in patients undergoing hemodialysis frequently results in significant morbidity and mortality. Attempts at prevention of CRBSI by catheter lock antibiotics, antibiotic combinations or solutions including Taurolidine have emerged over years. Objectives: To determine the role of taurolidine lock in presentation of Catheter related infection in hemodialysis. Design: Multicentre un-builded, r and omized controlled, non-inferiority trail. Period Jul 2012 to Dec 2013. Setting: Department of Nephrology, Fatima Memorial Hospital UHS Lahore. Methods: It was a multicentre, un-blinded, r and omized controlled, non-inferiority trial. Results: Out of 95 patients, total of 38 patients were r and omized into two groups. In group A catheters were locked with Taurolidine 2% and Heparin [5000IU/ml] equal to the catheter volume according to the protocol. In group B [control] catheters were locked with Heparin alone. 36 patients completed the study protocol. For primary end point analysis [30 days] the mean duration of catheter days was 27.25 + 5.5 days [median 30 days]. During this period of follow up only one patient from Group B had CRBSI resulting in a point incidence of CRBSI of 2.7%. Conclusions: Catheter lock with Taurolidine 2% in combination with heparin compared to heparin alone had no additional benefit in prevention of CRBSI. This however needs to be evaluated in a larger study using non cuffed temporary vascular access [TVA]