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Sodium citrate versus saline catheter locks for non-tunneled hemodialysis central venous catheters in critically ill adults: a randomized controlled trial.
- Source :
-
Intensive care medicine [Intensive Care Med] 2012 Feb; Vol. 38 (2), pp. 279-85. Date of Electronic Publication: 2011 Nov 29. - Publication Year :
- 2012
-
Abstract
- Purpose: Sodium citrate has antibacterial and anticoagulant properties that are confined to the catheter when used as a catheter lock. Studies of its use as a catheter lock in chronic hemodialysis patients suggest it may be efficacious in preventing infection and thrombotic complications. We compared sodium citrate with saline catheter locks for non-tunneled hemodialysis central venous catheters in critically ill adult patients. Primary endpoint was catheter life span without complication.<br />Methods: This was a randomized, controlled, open-label trial involving intensive care patients with acute renal failure requiring hemodialysis. Events were defined as catheter-related bloodstream infection and catheter malfunction.<br />Results: Seventy-eight patients were included. Median catheter life span without complication was 6 days (saline group) versus 12 days (citrate group) [hazard ratio (HR) 2.12 (95% CI 1.32-3.4), p = 0.0019]. There was a significantly higher rate of catheter malfunction in the saline group compared with in the citrate group (127 catheter events/1,000 catheter-days, saline group vs. 26 events/1,000 catheter-days, citrate group, p < 0.00001). There was no significant difference in incidence of infections between groups. We observed a significantly longer time to occurrence of infection in the citrate group (20 days vs. 14 days, HR 2.8, 95% CI 1.04-7.6, p = 0.04). By multivariate analysis, age and citrate group were the only independent factors that influenced catheter life span.<br />Conclusions: This study shows for the first time that citrate lock reduced catheter complications and increased catheter life span as compared to saline lock in critically ill adults requiring hemodialysis.
Details
- Language :
- English
- ISSN :
- 1432-1238
- Volume :
- 38
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Intensive care medicine
- Publication Type :
- Academic Journal
- Accession number :
- 22124771
- Full Text :
- https://doi.org/10.1007/s00134-011-2422-y