Heparin Stimulates
            <i>Staphylococcus aureus</i>
            Biofilm Formation

Shanks, Robert M. Q.; Donegan, Niles P.; Graber, Martha L.; Buckingham, Sarah; Zegans, Michael E.; Cheung, Ambrose L.; O’Toole, George A.

doi:10.1128/iai.73.8.4596-4606.2005

Cited by 254 publications

(196 citation statements)

References 64 publications

Supporting

Mentioning

184

Contrasting

Unclassified

Order By: Relevance

“…Instillation of high-concentration heparin remains the most common method of "locking" a catheter since it was introduced in the early 1970s. There is evidence that heparin stimulates the growth of biofilm in vitro and higher concentrations of heparin increase biofilm faster than lower concentrations [57]. However, a major complication of heparin locks, especially in the perioperative period, is bleeding due to unsuspected anticoagulation [58].…”

Section: B Preventing Contamination Of the Catheter Hubmentioning

confidence: 99%

Prevention of catheter-related bacteremia in children on hemodialysis: time for action

Stefanidis

2009

Pediatr Nephrol

View full text Add to dashboard Cite

This editorial commentary discusses the strategies for prevention of catheter-related bacteremia (CRB) in children on hemodialysis, which is associated with high morbidity and the increase of hospital cost. There is evidence that the use of arteriovenous fistulae in children on hemodialysis is associated with lower infection rates. Therefore, the use of catheters in these patients should be decreased by improving arteriovenous fistulae use rates or by increasing peritoneal dialysis patient recruitment. However, despite the wide adoption of such policies, hemodialysis catheters are still being used in a significant number of cases. For these patients, implementation of effective strategies for preventing contamination of the catheter hub should be a priority. The appropriate recording and evaluation of CRB rates are important for assessing preventive policies. In addition, the successful management of a CRB is essential for preventing recurrence of bacteremia. Recently it was documented in a number of randomized clinical trials that antimicrobial lock solutions were effective for preventing CRB. It is suggested that the use of antimicrobial locks should be considered in children who are at high risk of developing CRB, with caution for their long-term use, because of the possibility of bacterial resistance. Now is the time for action, and all preventive steps should be performed simultaneously to minimize the risk of CRB.

show abstract

Section: B Preventing Contamination Of the Catheter Hubmentioning

confidence: 99%

Prevention of catheter-related bacteremia in children on hemodialysis: time for action

Stefanidis

2009

Pediatr Nephrol

View full text Add to dashboard Cite

show abstract

“…The use of heparin is not risk free and in certain instances may actually cause harm, including infection (Shanks et al, 2005) and heparininduced thrombocytopenia (HIT) (Barclay et al, 2012). Additionally, treatments for diseases such as cancer involve the use of medications that can affect coagulation.…”

Section: Introductionmentioning

confidence: 99%

Heparin versus 0.9% sodium chloride intermittent flushing for the prevention of occlusion in long term central venous catheters in infants and children: A systematic review

Bradford

Edwards

Chan

2016

International Journal of Nursing Studies

View full text Add to dashboard Cite

Please cite this article as: Bradford, N.K., Edwards, R.M., Chan, R.J.,Heparin versus 0.9% sodium chloride intermittent flushing for the prevention of occlusion in long term central venous catheters in infants and children: a systematic review, International Journal of Nursing Studies (2016), http://dx.doi.org/10. 1016/j.ijnurstu.2016.02.014 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. AbstractBackground

show abstract

“…A recent study reported a higher frequency of hemorrhagic complications after placement of a new dialysis catheter in patients receiving a high-concentration heparin lock (7). Higher heparin concentrations have also been implicated in promoting the formation of Staphylococcus aureus biofilm (8,9). On the basis of these observations, a recent position paper recommended that a 1000 units/ml heparin solution be adopted as the standard concentration for locking hemodialysis catheters (10).…”

mentioning

confidence: 99%

Does the Heparin Lock Concentration Affect Hemodialysis Catheter Patency?

Ivan

Smith

Allon

2010

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

Background and objectives: Concentrated heparin solutions are instilled into the catheter lumens after each hemodialysis session to prevent catheter thrombosis. The heparin lock concentration at many centers has been decreased recently to reduce the risk of systemic bleeding and contain costs. However, the effect of this change on catheter patency is unknown. We compared catheter patency between two heparin lock solutions: 1000 versus 5000 units/ml. Design, setting, participants, & measurements: With use of a prospective, computerized, vascular access database, 105 patients with newly placed tunneled hemodialysis catheters, including 58 patients receiving a 5000 units/ml heparin lock and 47 patients receiving a 1000 units/ml heparin lock, were retrospectively identified. The primary endpoint was cumulative catheter patency and the secondary endpoint was frequency of thrombolytic instillation.Results: Cumulative catheter survival was similar in the two groups, being 71% versus 73% at 120 days in the low-and high-concentration heparin lock groups (hazard ratio of catheter failure, 0.97; 95% confidence interval, 0.45 to 2.09; P ‫؍‬ 0.95). The frequency of tissue plasminogen activator instillation was significantly greater in the low-concentration heparin group (hazard ratio, 2.18; 95% CI, 1.26 to 3.86; P ‫؍‬ 0.005). No major bleeding complications were observed in either treatment group. The overall drug cost for maintaining catheter patency was 23% lower with the low-concentration heparin lock ($1418 versus $1917) to maintain catheter patency for 1000 days.Conclusions: Low-concentration heparin lock solutions do not decrease cumulative dialysis catheter patency, but require a twofold increase in thrombolytic instillation to maintain long-term patency.

show abstract

Heparin Stimulates Staphylococcus aureus Biofilm Formation

Cited by 254 publications

References 64 publications

Prevention of catheter-related bacteremia in children on hemodialysis: time for action

Prevention of catheter-related bacteremia in children on hemodialysis: time for action

Heparin versus 0.9% sodium chloride intermittent flushing for the prevention of occlusion in long term central venous catheters in infants and children: A systematic review

Does the Heparin Lock Concentration Affect Hemodialysis Catheter Patency?

Contact Info

Product

Resources

About