| Prevention of Tunneled Cuffed Hemodialysis Catheter-Related Dysfunction and Bacteremia by a Neutral-Valve Closed-System Connector: A Single-Center Randomized Controlled Trial. | |
| | |
MedLine Citation:
|
PMID: 23228946 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
BACKGROUND: Hemodialysis (HD) tunneled cuffed catheters may be fitted with neutral-valve closed-system connectors. Such connectors, which are flushed with saline solution and used for 3 consecutive HD sessions, provide a mechanically closed positive-pressure barrier and potentially may be useful to prevent catheter-related bacteremia and dysfunction. STUDY DESIGN: Single-center randomized controlled trial. SETTING & PARTICIPANTS: 66 adult HD patients with a tunneled cuffed catheter. INTERVENTION: Neutral-valve closed-system connector (Tego Needlefree Hemodialysis Connector) versus trisodium citrate, 46.7%, locking solution (Citra-Lock; control group). OUTCOMES: Primary composite outcome was the incidence rate of catheter-related dysfunction or bacteremia. Secondary outcomes were the separate incidence rates of catheter-related dysfunction and bacteremia and the cost of both procedures. MEASUREMENTS: Catheter dysfunction was defined as the requirement of urokinase and/or a mean blood flow ≤250 mL/min during 2 consecutive HD sessions. Catheter-related bacteremia was defined as ≥2 positive blood cultures. Time of catheter use was calculated and the incidence rate of complications was expressed per 100 person-years. RESULTS: 66 patients were followed up for a median of 86 (IQR, 29-200) days. The composite primary outcome was not significantly reduced in the closed-system-connector intervention group versus the citrate-locking-solution control group (63.56 vs 71.51 per 100 person-years; P = 0.3). Catheter dysfunction in the intervention group was not decreased versus controls (59.59 vs 51.64 per 100-person-years; P = 0.9). Only 6 catheter-related bacteremia events were identified, one in the intervention group (3.97 vs 19.86 per 100 person-years; P = 0.06). LIMITATIONS: Small size of the patient population and single-center study. CONCLUSIONS: Superiority of the closed-system connector in terms of prevention of the primary efficacy end point compared to the standard locking solution was not observed. Further evaluation in a larger study is suggested. |
| | |
Authors:
|
Florence Bonkain; Judith Racapé; Isabelle Goncalvez; Micheline Moerman; Olivier Denis; Nadia Gammar; Karine Gastaldello; Joëlle L Nortier |
Related Documents
:
|
10735426 - External beam irradiation as an adjunctive treatment in failing dialysis shunts. 1617706 - Initial and long-term results of percutaneous transluminal coronary angioplasty in pati... 18771886 - Successful lower extremity angioplasty improves brachial artery flow-mediated dilation ... 8049976 - Role of bypass, endarterectomy, extra-anatomic bypass and endovascular surgery in unila... 20394246 - Comparing two methods of lma insertion; classic versus simplified (airway). 7999656 - Effects of combined perioperative epidural bupivacaine and morphine, ibuprofen, and inc... |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2012-12-7 |
Journal Detail:
|
Title: American journal of kidney diseases : the official journal of the National Kidney Foundation Volume: - ISSN: 1523-6838 ISO Abbreviation: Am. J. Kidney Dis. Publication Date: 2012 Dec |
Date Detail:
|
Created Date: 2012-12-11 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8110075 Medline TA: Am J Kidney Dis Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
|
Copyright © 2012 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved. |
Affiliation:
|
Department of Nephrology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Performance of urinary liver-type fatty acid-binding protein in acute kidney injury: a meta-analysis...
Next Document: Timing of Recanalization After Intravenous Thrombolysis and Functional Outcomes After Acute Ischemic...