Nurse filling a syringe with catheter lock solution. This is an antimicrobial agent that prevents pathogens from infecting the blood vessel catheters of chronic dialysis patients after treatment. LIFE IN VIEW/SCIENCE PHOTO LIBRARY

Rehabilitation for coma patient. Nurses using a sling to move a coma patient from their bed for a rehabilitation session. MASSIMO BREGA/SCIENCE PHOTO LIBRARY

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The US Food and Drug Administration (FDA) has approved DefenCath® catheter lock solution to reduce the incidence of catheter-related bloodstream

Background Tunnelled central venous dialysis catheter use is significantly limited by the occurrence of catheter-related infections. This randomised controlled trial assessed the efficacy of a 48 hour 70% ethanol lock vs heparin locks in prolonging the time to the first episode of catheter related blood stream infection (CRBSI). Methods Patients undergoing haemodialysis (HD) via a tunnelled catheter were randomised 1:1 to once per week ethanol locks (with two heparin locks between other dialysis sessions) vs thrice per week heparin locks. Results Observed catheter days in the heparin (n=24) and ethanol (n=25) groups were 1814 and 3614 respectively. CRBSI occurred at a rate of 0.85 vs. 0.28 per 1000 catheter days in the heparin vs ethanol group by intention to treat analysis (incident rate ratio (IRR) for ethanol vs. heparin 0.17; 95%CI 0.02-1.63; p=0.12). Flow issues requiring catheter removal occurred at a rate of 1.6 vs 1.4 per 1000 catheter days in the heparin and ethanol groups respectively (IRR 0.85; 95% CI 0.20-3.5 p =0.82 (for ethanol vs heparin). Conclusions Catheter survival and catheter-related blood stream infection were not significantly different but there was a trend towards a reduced rate of infection in the ethanol group. This study establishes proof of concept and will inform an adequately powered multicentre trial to definitively examine the efficacy and safety of ethanol locks as an alternative to current therapies used in the prevention of catheter-associated blood stream infections in patients dialysing with tunnelled catheters. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12609000493246

The antithrombotic characteristics of Heparin and the viscous nature of glycerol or dextrose are combined in a solution to promote and extend the patency of vascular cathetersThese infusion supplies are designed to be suitable for use in applications in data acquisition in laboratory environments ranging from mice to large animals. Tethers of various lengths and types are used to keep animals from running away, and swivels allow for a certain circumference of movement. All units are tested in pressures that exceed industry standards for laboratory testing, and parts that may come into contact with infused fluid are made of inert stainless steel and a fluoropolymer resin.

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