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Clinical effectiveness of 4% tetrasodium EDTA as a routine non-antibiotic antimicrobial lock solution in central venous access devices of hemodialysis and TPN patients against the TripleThreat™: An 18-month Canadian experience

2018· preprint· en· W4213378197 on OpenAlexaffabout
Chantal Lainesse

Bibliographic record

Venuenot available
Typepreprint
Languageen
FieldHealth Professions
TopicCentral Venous Catheters and Hemodialysis
Canadian institutionsSt. Paul's Hospital
Fundersnot available
KeywordsHemodialysisLock (firearm)AntimicrobialAntibioticsMedicineIntensive care medicineInternal medicineMicrobiologyEngineeringBiology

Abstract

fetched live from OpenAlex

Introduction: The ideal catheter lock solution should be able to prevent the occurrence of the TripleThreatu2122 of clot, bacterial colonisation and biofilm formation. Providing an effective barrier for the inside of central venous access devices (CVADs) must be part of the multimodal approach to decrease the risk of catheter related complications such as catheter related bloodstream infections (CRBSI) and occlusions. However, this lock solution should not contribute to increasing the risk of antimicrobial resistance (AMR) and/or bleeding episodes. The in vitro effectiveness of a novel non-antibiotic antimicrobial solution of 4% tetrasodium EDTA was confirmed against biofilms formed by clinically relevant bacteria and fungi. The anticoagulant property of EDTA is well known and trusted. Therefore, the objective was to collect post approval safety and efficacy data from the use of this catheter lock solution in Canadian patients compared to the standard of care.Methods: Hemodialysis and TPN patients with CVADs were selected across Canada according to their high risk of CRBSI and alteplase use. Results: Canadian data collected over the last 18 months show both a clinically relevant decrease in CRBSI and alteplase use when the standard lock solution was replaced by 4% tetrasodium EDTA. The most frequent use of this lock solution was once a day in TPN patients with no safety concerns. Hypocalcemia was not observed with its use over time. Discussion and Conclusion: Results highlight the ability of 4% tetrasodium EDTA to reduce bacterial burden and biofilms in CVADs as well as providing well-established anticoagulant activities. Its multiple modes of action should prevent resistance from arising, protecting against catheter colonization and subsequent CRBSI, in patients with CVADs independent of medical condition. Tetrasodium EDTA is a safe and effective non-antibiotic antimicrobial lock solution in a time when the threat of AMR u201csuperbugsu201d is real and increasing.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.003
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.426
Threshold uncertainty score0.847

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0010.003
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.001
Bibliometrics0.0000.001
Science and technology studies0.0020.001
Scholarly communication0.0010.000
Open science0.0010.001
Research integrity0.0010.001
Insufficient payload (model declined to judge)0.0010.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.050
GPT teacher head0.395
Teacher spread0.344 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

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Citations0
Published2018
Admission routes2
Has abstractyes

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