To the Editor—There is increasing evidence that antimicrobial locks applied within the catheter lumen are effective at preventing catheter-related bloodstream infection (CRBSI), a source of substantial morbidity and mortality in patients receiving hemodialysis (HD). Therefore, we read with interest the recently published review article by John Boyce that, in addition to providing a comprehensiv...

Hemodialysis-related-heparin-induced thrombocytopenia (HD-HIT) is a drug-induced, immunoglobulinmediated disorder that it is suspected in dialysis patients with an unexpected fall in the platelet count, and/or unexplained thrombotic events, particularly visible clotting in the circuit under an adequate heparin dose, that begins between 5 and 10 days (nadir between 7 and 30 days, mostly by the t...

OBJECTIVE Critically ill neonates are at high risk for vascular catheter-related bloodstream infection (CRBSI), most often caused by coagulase-negative staphylococci. Most CRBSIs with long-term devices derive from intraluminal contaminants. The objective of this study was to ascertain the safety and the efficacy of a vancomycin-heparin lock solution for prevention of CRBSI. METHODS A prospect...

Abstract Background and Aims In hemodialysis (HD) patients, the majority of bloodstream infections are caused by infection vascular access catheters. Commonly, Central venous catheters (CVCs) only option when HD is needed for patients without definitive access. However, in addition to infection, CVCs associated with other complications, such as thrombosis, dysfunction, leading higher mortality ...

The contribution of Arg(129) of the serpin, antithrombin, to the mechanism of allosteric activation of the protein by heparin was determined from the effect of mutating this residue to either His or Gln. R129H and R129Q antithrombins bound pentasaccharide and full-length heparins containing the antithrombin recognition sequence with similar large reductions in affinity ranging from 400- to 2500...

Objective: To determine whether high concentrations of antibiotic “locked” into a central venous catheter with heparin would retain sufficient antimicrobial activity to inhibit the growth of organisms commonly causing catheter-related infections in patients undergoing hemodialysis. Methods: Cefazolin, vancomycin, ceftazidime (all at final concentrations of 10 mg/mL), and gentamicin (final conce...

BACKGROUND The incidence of acute kidney injury (AKI) is estimated at 10 to 20% in patients admitted to intensive care units (ICU) and often requires renal replacement therapy (RRT). ICU mortality in AKI patients can exceed 50%. Venous catheters are the preferred vascular access method for AKI patients requiring RRT, but carry a risk of catheter thrombosis or infection. Catheter lock solutions ...

BACKGROUND Antimicrobial lock therapy has been widely utilized internationally for the prevention and management of intravascular catheter-related bloodstream infections. One of the agents commonly utilized for lock therapy is ethanol. However, a systematic review of adverse events associated with ethanol locks has not been published. METHODS PubMed was searched to collect articles published ...

Abstract Background and Aims CRBSI is a dreaded complication of permcath, with reported incidence 1.1 – 5.5 episodes/1000 days. Many these patients especially those infected Staphylococcus aureus, Pseudomonas aeruginosa or fungal growth require catheter removal. 70% alcohol possibly breaks the biofilm in exposes hidden bacteria to antibiotics. This study was done find usefulness lock establishe...