Sodium citrate versus saline catheter locks for non-tunneled hemodialysis central venous catheters in critically ill adults: a randomized controlled trial View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2011-11-29

AUTHORS

Laure Hermite, Jean-Pierre Quenot, Abdelouaid Nadji, Saber David Barbar, Pierre-Emmanuel Charles, Maël Hamet, Nicolas Jacquiot, François Ghiringhelli, Marc Freysz

ABSTRACT

PurposeSodium 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.MethodsThis 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.ResultsSeventy-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.ConclusionsThis 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. More... »

PAGES

279-285

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00134-011-2422-y

DOI

http://dx.doi.org/10.1007/s00134-011-2422-y

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1042506582

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/22124771


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