How much is red blood cell fragmentation increased by the use of closed luer lock access devices on catheter hubs?
نویسندگان
چکیده
The opening and manipulation of central venous (CV) catheters before and after each dialysis event might result in catheter-related blood stream infections [1–3]. In order to reduce those infection risks, different types of closed luer lock access devices are commercially available. Such connectors are placed on the arterial and venous catheter hub and are designed with a split septum of medical grade silicon such that they can stay safely in place during the interdialytic period as well as during dialysis. Besides the proven microbiological efficacy in infection reduction and/or elimination [4–6], those types of connectors are designed to apply with blood flows up to 600 mL/min during dialysis and to create an unobstructed fluid path in the open position, with an equivalent resistance compared to a direct connection of male and female luer. Although those closed luer lock access devices do not contain mechanical valves that could cause haemolysis, no data are known on whether the split septum fully opens and does not exert any additional resistances to the blood flow. Since no data were known on these resistances, we previously investigated in vitro the flow resistance through three different closed luer lock access devices [7]: BD QSyteTM (Beckton-Dickinson, USA), second edition TegoTM (ICU Medical, USA) and Swan Lock connector (Codan, Germany) (Figure 1). This in vitro study revealed that pressure drops over the three connector types were attributable to the position and opening system of the silicon split septum. Additional resistances to blood flow were minimal in the TegoTM and Codan connectors, while they were significant in BD Q-SyteTM. In order to assess whether those resistances are in the safe range or not, the present clinical study was set up to study the absence or incidence of red blood cell fragmenta-
منابع مشابه
How much is catheter flow influenced by the use of closed luer lock access devices?
BACKGROUND To reduce infection risks in patients on hemodialysis with a long term central venous catheter, different types of closed luer lock access devices are used on the arterial and venous catheter hub. Although those connectors create a mechanically and microbiologically closed system in between two dialysis sessions, no data are available on the resistance those connectors exert on the b...
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