#3717 Early outcomes of KiteLock (EDTA 4%): a new CVC locking solution
Bibliographic record
Abstract
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.
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 distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
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".