Review of different types of Taurolidine central venous catheter lock solution

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In this prospective, randomized, controlled trial, patients were randomized to receive either Taurolock/Hep or Taurolock/U and were followed for 6 months” Al-Ali et al (2017).

Abstract:

BACKGROUND: Taurolidine citrate with heparin (Taurolock/Hep) is a promising central venous catheter lock solution. Despite its universal use among our hemodialysis patients, the prevalence of catheter malfunction was high. We aimed to compare Taurolock/Hep and taurolidine citrate with urokinase (Taurolock/U) as a catheter lock solution in order to identify whether either solution could reduce catheter-related dysfunction.

METHODS: In this prospective, randomized, controlled trial, patients were randomized to receive either Taurolock/Hep or Taurolock/U and were followed for 6 months. Episodes of acute catheter thrombosis, requirement of recombinant tissue plasminogen activator (rt-PA) and incidence of catheter-related blood stream infection (CRBSI) were recorded, along with dialysis adequacy ( Kt / V ), blood flow rates (BFRs) and adverse events.

RESULTS: There were 93 inclusions (85 patients) in the Taurolock/Hep group and 84 inclusions in the Taurolock/U group (79 patients). Three catheters were removed in the Taurolock/Hep group because of acute thrombosis, while no catheter was removed for the same reason in the Taurolock/U group. The total number of all-causes catheter exchange (acute thrombosis and CRBSI) was significantly lower in Taurolock/U group (P = 0.028). rt-PA was used significantly less often in the Taurolock/U group than in the Taurolock/Hep group (P = 0.006). Moreover, higher BFR and Kt / V were noted in the Taurolock/U group than in the Taurolock/Hep group, although the differences were not uniformly significant.

CONCLUSION: Taurolock/U is a safe and effective tunneled dialysis catheter lock solution, with a low rate of catheter exchange.

Reference:

Al-Ali, F., Hamdy, A.F., Hamad, A., Elsayed, M., Zafar Iqbal, Z., Elsayed, A., Ibrahim, R., Tolba, H., Buanan, H. and Fawzy, A. (2017) Safety and efficacy of taurolidine/urokinase versus taurolidine/heparin as a tunneled catheter lock solution in hemodialysis patients: a prospective, randomized, controlled study. [epub ahead of print].

doi: 10.1093/ndt/gfx187.

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