Surface properties and bacterial adhesion on polyurethane central catheters: Impact of ethanol lock solution

Khzam, Afif; Saunier, Johanna; Guilbaud, Morgan; Herry, Jean‐Marie; Dazzi, Alexandre; Tortolano, Lionel; Carpentier, L; Mignot, Agnès; Yagoubi, Najet

doi:10.1016/j.bioadv.2023.213281

Cited by 3 publications

(3 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similarly, no structural differences were noted in polyurethane catheters exposed to ethanol when assessed with scanning electron microscopy, although investigation with mass spectroscopy revealed very low amounts of polyurethane compounds released after exposure to ethanol (20). Thus, it appears that the newer formulations of polyurethane catheters may be less affected by ethanol than those of previous generations with little effect on surface properties in relation to bacterial adhesion (21, 22).…”

Section: Discussionmentioning

confidence: 99%

“…exposure to ethanol (20). Thus, it appears that the newer formulations of polyurethane catheters may be less affected by ethanol than those of previous generations with little effect on surface properties in relation to bacterial adhesion (21,22). With growing confidence in ethanol safety in polyurethane catheters and its success in CLABSI prevention with silicone catheters (23), lock therapy has been introduced as a potential method of improving CLABSI prevention in outpatient polyurethane catheters.…”

Section: At the Bedsidementioning

confidence: 99%

See 1 more Smart Citation

Safety and Efficacy of Ethanol for Catheter Salvage and Central Line-Associated Bloodstream Infection Prophylaxis in Polyurethane Catheters in the PICU

Weber,

Woods-Hill,

Resendiz

et al. 2024

Pediatric Critical Care Medicine

View full text Add to dashboard Cite

OBJECTIVES: Ethanol lock therapy (ELT) is a potential method of central catheter salvage following central line-associated bloodstream infection (CLABSI) although there is potential risk of catheter damage in polyurethane catheters. Further, there is limited efficacy data across the spectrum of common pediatric catheters, and published ELT protocols describe dwell times that are not feasible for critically ill children. We sought to evaluate the safety and efficacy of ELT in polyurethane catheters using brief (30 min to 2 hr) dwell times in our PICU. DESIGN: Investigational pilot study using historical control data. SETTING: PICU in quaternary care, free-standing children’s hospital. INTERVENTIONS: ELT in polyurethane central venous catheters for catheter salvage. RESULTS: ELT with brief dwell times was used in 25 patients, 22 of whom were bacteremic. Ultimately 11 patients, comprising 14 catheters, were diagnosed with a primary CLABSI. The catheter salvage rate in primary CLABSI patients receiving ELT was 92% (13/14) and significantly higher than the salvage rate in patients receiving antibiotics alone (non-ELT) (62%, 39/64; mean difference 0.32, 95% CI [0.14–0.50], p = 0.03). The rate of catheter fracture in all patients receiving ELT was 8% (2/25) while the rate of fracture in the non-ELT group was 13% (8/64; mean difference –0.05, 95% CI [–0.18 to 0.09], p = 0.72). The rate of tissue plasminogen activator (tPA) use in the ELT group was 8% (2/25), whereas the rate of tPA use in the non-ELT group was significantly higher at 42% (26/64; mean difference –0.34, 95% CI [–0.49 to –0.17], p = 0.002). CONCLUSIONS: The use of ELT for catheter salvage and prophylaxis in the PICU is safe in a variety of polyurethane catheters. Dwell times ranging from 30 minutes to 2 hours were effective in sterilizing the catheters while allowing other therapies to continue. This approach may decrease the need for frequent line changes in a medically fragile pediatric population.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: At the Bedsidementioning

confidence: 99%

Safety and Efficacy of Ethanol for Catheter Salvage and Central Line-Associated Bloodstream Infection Prophylaxis in Polyurethane Catheters in the PICU

Weber,

Woods-Hill,

Resendiz

et al. 2024

Pediatric Critical Care Medicine

View full text Add to dashboard Cite

show abstract

“…Examples of complications include ethanol toxicity, protein precipitation within the CVC causing occlusion, and mechanical degradation of the catheter itself. [12][13][14][15] The nonantibiotic antimicrobial taurolidine has also been studied extensively in many clinical applications at 1.35% and 2% concentrations, including as a catheter lock solution, surgical antiseptic, and antiadhesion agent, and as an antineoplastic agent. [16][17][18] With a unique mechanism of action, favorable safety profile, and the available data of its benefit for the prevention of CRBSI, taurolidine and heparin catheter lock solution is now the first antimicrobial catheter lock solution approved by the US Food and Drug Administration (FDA).…”

Section: Introductionmentioning

confidence: 99%

Taurolidine and Heparin as Catheter Lock Solution for Central Venous Catheters in Hemodialysis

Nguyen,

Camins,

Butler

2024

American Journal of Therapeutics

View full text Add to dashboard Cite

Background: Chronic kidney disease can lead to end-stage renal disease, and the prevalence is increasing. Many patients starting hemodialysis require central venous catheters (CVCs). Catheter-related bloodstream infections (CRBSIs) are a common complication and lead to significant morbidity and mortality. Interventions to prevent CRBSI include antimicrobial lock therapy but concern for the development of antimicrobial resistance and adverse effects. Nonantimicrobial antiseptics as catheter lock solutions have also been used. Taurolidine and heparin catheter lock solution is first approved by the Food and Drug Administration for the prevention of CRBSI in patients on hemodialysis. Taurolidine has a unique mechanism of action and favorable safety profile. Mechanism of Action, Pharmacodynamics, and Pharmacokinetics: Taurolidine and heparin catheter lock solution have both antimicrobial and anticoagulant properties. Taurolidine is derivative of the amino acid taurine, and heparin is derived from porcine intestinal mucosa. Taurolidine not only damages microbial cell walls but also prevents the adherence of microorganisms to biological surfaces, preventing biofilm formation. Taurolidine and heparin catheter lock solution is intended to be used intraluminally within the catheter and should be aspirated. Because it is used locally, limited pharmacokinetic and pharmacodynamic data are available. Clinical Trials: The LOCK-IT-100 trial is a randomized, double-blind, phase 3 study, which included 795 end-stage renal disease patients on hemodialysis with CVC. Taurolidine and heparin was compared with the control heparin alone. The results of the study showed a 71% risk reduction in CRBSI for taurolidine and heparin arm (95% confident interval, 38%–86%, P = 0.0006). Other studies have also shown that taurolidine lock solution leads to decreased CRBSI episodes. Several systematic reviews and meta-analysis consisted of taurolidine in adult, and pediatric populations also showed reduction in the incidence of CRBSIs. Therapeutic Advance: Taurolidine and heparin lock solution represents a novel preventive strategy for those undergoing hemodialysis through a CVC by reducing the risk of CRBSI. This is significant progress because there are no other similar options available for patients for whom catheters are the only options for their life-saving treatment.

show abstract

Impact of lock solutions on the mechanical performance of polyurethane central venous catheters: A comparative study

Khzam

Saunier

Carpentier

et al. 2023

Medical Engineering & Physics

View full text Add to dashboard Cite

Surface properties and bacterial adhesion on polyurethane central catheters: Impact of ethanol lock solution

Cited by 3 publications

References 36 publications

Safety and Efficacy of Ethanol for Catheter Salvage and Central Line-Associated Bloodstream Infection Prophylaxis in Polyurethane Catheters in the PICU

Safety and Efficacy of Ethanol for Catheter Salvage and Central Line-Associated Bloodstream Infection Prophylaxis in Polyurethane Catheters in the PICU

Taurolidine and Heparin as Catheter Lock Solution for Central Venous Catheters in Hemodialysis

Impact of lock solutions on the mechanical performance of polyurethane central venous catheters: A comparative study

Contact Info

Product

Resources

About