#3717 Early outcomes of KiteLock (EDTA 4%): a new CVC locking solution
Notice bibliographique
Résumé
Abstract Background and Aims Tunneled hemodialysis (HD) central venous catheter (CVC) use is often complicated by CVC dysfunction, typically due to intraluminal or extraluminal thrombus or fibrin sheath formation which interferes with blood flow through the CVC lumen. Interdialytic CVC “locking” with heparin or citrate of various concentrations is commonly used as prophylaxis. Despite this, CVC dysfunction remains common, often requiring repeated installations of thrombolytic agent (r-TPA), CVC exchange or fibrin sheath disruption to manage CVC dysfunction. KiteLock™ (EDTA 4%), is a new CVC locking solution that has anticoagulant and anti-infective properties. We compared the rates of r-TPA use and CVC exchange in patients at high risk of CVC dysfunction who received CVC locking with citrate 4% (Period I) and KiteLock (Period II). Method This was a prospective cohort study of long-term HD patients (3x/week for 4hours/treatment) in a large academic incentre dialysis facility who required tunneled CVC and deemed at high risk of CVC dysfunction. High risk CVC patients were defined as those who required 3 or more installations of TPA in a 14 day period despite use of citrate 4% lock. Patients’ CVCs were locked with citrate 4% from Dec 19 2022 to Dec 18 2023 (Period I). From January 1 2024 to June 30 2024 (Period II), high risk patients were locked with KiteLock (EDTA 4%). The CVC locking procedure was the same for both citrate 4% and KiteLock (EDTA 4%) solutions, with the venous and arterial ports filled to their volume with the respective locking solutions. In both study periods, patients were followed weekly to capture r-TPA use and CVC exchange (ordered at the discretion of attending nephrologist) and CVC-related bacteremia events (determined by a separate infection control committee). Data was cross checked via nursing flowsheets, and reports in the electronic medical records (EPIC). Results In the study period, 496 patients used tunnelled CVCs, 106 patients received r-TPA, and 39 patients were deemed high risk. In Period I there were 5021 CVC days and in Period II there were 3768 CVC days. Figure 1 illustrates the rates of r-TPA use and CVC exchanges (in high risk patients) and CVC-related bacteremia (for all patients) in the two study periods. In patients at high risk of CVC dysfunction, compared to CVC locked with citrate, those locked with KiteLock showed: 33% reduction in r-TPA use per 1000 CVC days. 11% reduction in the rate of CVC exchange per 1000 CVC days. Conclusion This prospective cohort study showed that patients at high risk of CVC dysfunction had a lower rate of r-TPA use and CVC exchange when their CVC were locked with KiteLock (EDTA 4%) compared with citrate 4%. Further study is required in a rigorously conducted clinical trial.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».