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Mechanical Integrity of Hemodialysis Catheters after Exposure to a Novel Catheter Lock Solution

  • Saima Aslam (a1) and Rabih O. Darouiche (a1)

Extract

Objective.

To examine the mechanical integrity of hemodialysis catheters after exposure to the combination of N-acetylcysteine, ti-gecycline, and heparin, compared with that of catheters exposed to heparin alone.

Methods.

We used 3 types of hemodialysis catheters: polyurethane, silicone, and carbothane catheters. Catheter segments were incubated in vitro for various time intervals of up to 2 weeks either in a novel catheter lock solution (novel CLS), which consisted of N-acetylcysteine, tigecycline, and heparin, or in heparin alone (as a control). At the time of testing, each segment was rinsed and cut longitudinally into 2 sections. All catheter sections were scanned using an optical dissecting microscope to check for surface abnormalities and to measure wall thickness. We also carried out tensile strength testing of another set of catheters using a universal testing machine. Tested parameters included stress at yield, strain at yield, stress at break, strain at break, modulus of elasticity, and force at break.

Results.

The surfaces of catheters in both groups appeared similar by microscopy. The mean thickness of the catheter wall was not significantly different for the catheters exposed to the novel CLS and the catheters exposed to heparin (P >.05). Results for most of the tensile strength parameters tested were similar in the 2 groups of catheters at the end of 2 weeks of incubation. In particular, the force-at-break value of all tested catheters remained much greater than that recommended by industry standards.

Conclusions.

The use of the novel catheter lock solution did not impair the mechanical integrity or increase the propensity for fracture of hemodialysis catheters.

Copyright

Corresponding author

Section of Infectious Diseases, Room 4B-370, Michael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Boulevard, Houston, TX (saslam@bcm.edu)

References

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1.U.S. Renal Data System. USRDS 2009 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States. Befhesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2009.
2.Ishani, A, Collins, AJ, Herzog, CA, Foley, RN. Septicemia, access and cardiovascular disease in dialysis patients: the USRDS Wave 2 study. Kidney Int 2005;68(1):311318.
3.Tokars, II, Finelli, L, Alter, MJ, Arduino, MI. National surveillance of dialysis-associated diseases in the United States, 2001. Semin Dial 2004;17(4):310319.
4.Aslam, S. Effect of antibacterials on biofilms. Am J Infect Control 2008;36(10):S175; e179-111.
5.Aslam, S, Trautner, BW, Ramanathan, V, Darouiche, RO. Pilot trial of N-acetylcysteine and tigecycline as a catheter-lock solution for treatment of hemodialysis catheter-associated bacteremia. Infect Control Hosp Epidemiol 2008;29(9):894897.
6.Bell, AL, Jayaraman, R, Vercaigne, LM. Effect of ethanol/trisodium citrate lock on the mechanical properties of carbothane hemodialysis catheters. Clin Nephrol 2006;65(5):342348.
7.Guenu, S, Heng, AE, Charbonne, F, et al.Mass spectrometry and scanning electron microscopy study of silicone tunneled dialysis catheter integrity after an exposure of 15 days to 60% ethanol solution. Rapid Commun Mass Spectrom 2007;21(2):229236.
8.International Organization for Standardization (ISO). ISO 10555-1: Sterile, Single-Use Intravascular Catheters. Amendment 2, Part 1. Geneva, Switzerland; ISO; 2004.
9.Aslam, S, Trautner, BW, Ramanathan, V, Darouiche, RO. Combination of tigecycline and N-acetylcysteine reduces biofilm-embedded bacteria on vascular catheters. Antimicrob Agents Chemother 2007;51(4):15561558.
10.McHugh, GJ, Wild, DJ, Havill, JH. Polyurethane central venous catheters, hydrochloric acid and 70% ethanol: a safety evaluation. Anaesth Intensive Care 1997;25(4):350353.
11. Covidien Kendall Web site. Vascular Therapies web page. Covidien Kendall, 2009. http://www.kendallhealthcare/vasculartherapy/pageBuilder.aspx?topicID=81037. Accessed March 23, 2010.

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