TEMPORARY HEMODIALYSIS

Catheter related blood stream infections (CRBSI) in patients undergoinghemodialysis frequently results in significant morbidity and mortality. Attempts at prevention ofCRBSI by catheter lock antibiotics, antibiotic combinations or solutions including Taurolidinehave emerged over years. Objectives: To determine the role of taurolidine lock in presentationof Catheter related infection in hemodialysis. Design: Multicentre un-builded, randomizedcontrolled, 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, randomizedcontrolled, non-inferiority trial. Results: Out of 95 patients, total of 38 patients were randomizedinto 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 werelocked with Heparin alone. 36 patients completed the study protocol. For primary end pointanalysis (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 pointincidence of CRBSI of 2.7%. Conclusions: Catheter lock with Taurolidine 2% in combinationwith heparin compared to heparin alone had no additional benefit in prevention of CRBSI. Thishowever needs to be evaluated in a larger study using non cuffed temporary vascular access(TVA).