TEMPORARY HEMODIALYSIS; TAUROLIDINE LOCK TO PREVENT CATHETER-RELATED BLOOD STREAM INFECTIONS

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, randomized 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, randomized controlled, non-inferiority trial. Results: Out of 95 patients, total of 38 patients were randomized 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).