Trisodium citrate induced protein precipitation in haemodialysis catheters might cause pulmonary embolism

Nephrology Dialysis Transplantation

Volumn 27, Issue 7, 2012, Pages 2953-2957

  Schilcher, Gernot ^a   Scharnagl, Hubert ^a   Horina, Joerg H ^a   Ribitsch, Werner ^a   Rosenkranz, Alexander R ^a   Stojakovic, Tatjana ^a   Polaschegg, Hans Dietrich ^a,b  

^a MEDICAL UNIVERSITY OF GRAZ   (Austria)

^b Medical Devices Consultant ^*  (Austria)

Author keywords

central venous catheter; haemodialysis access; lock spillage; protein precipitation; trisodium citrate lock solution

Indexed keywords

ALBUMIN; CITRATE TRISODIUM; PROTEIN;

ARTICLE; BLOOD ANALYSIS; CENTRAL VENOUS CATHETER; CONCENTRATION (PARAMETERS); HEMODIALYSIS; HUMAN; HUMAN CELL; IN VITRO STUDY; IN VIVO STUDY; LUNG EMBOLISM; MALE; PATHOPHYSIOLOGY; PRECIPITATION; PRIORITY JOURNAL; PROTEIN ANALYSIS; PROTEIN FUNCTION;

ANTICOAGULANTS; CATHETERS, INDWELLING; CHEMICAL PRECIPITATION; CITRATES; HUMANS; PROGNOSIS; PROTEINS; PULMONARY EMBOLISM; RENAL DIALYSIS; RENAL INSUFFICIENCY, CHRONIC;

EID: 84864400410     PISSN: 09310509     EISSN: 14602385     Source Type: Journal    
DOI: 10.1093/ndt/gfs048     Document Type: Article

References (34)

1. Rayner HC, Pisoni RL. The increasing use of hemodialysis catheters: evidence from the DOPPS on its significance and ways to reverse it. Semin Dial 2010; 23: 6-10.
2. Pisoni RL, Young EW, Dykstra DM et al. Vascular access use in Europe and the United States: results from the DOPPS. Kidney Int 2002; 61: 305-316.
3. Moran JE, Ash SR. ASDIN Clinical Practice Committee. Locking solutions for hemodialysis catheters; heparin and citrate-a position paper by ASDIN. Semin Dial 2008; 21: 490-492.
4. MacRae JM, Dojcinovic I, Djurdjev O et al. Citrate 4% versus heparin and the reduction of thrombosis study (CHARTS). Clin J Am Soc Nephrol 2008; 3: 369-374.
5. Weijmer MC, van den Dorpel MA, Van de Ven PJ et al. Randomized, clinical trial comparison of trisodium citrate 30% and heparin as catheter-locking solution in hemodialysis patients. J Am Soc Nephrol 2005; 16: 2769-2777.
6. FDA: Food and Drug Administration. FDA issues warning on triCitrasol dialysis catheter anticoagulant. FDA Talk Paper 2000; 14: T00-T16.
7. Polaschegg HD, Sodemann K. Risks related to catheter locking solutions containing concentrated citrate. Nephrol Dial Transplant 2003; 18: 2688-2690.
8. Punt CD, Boer WE. Cardiac arrest following injection of concentrated trisodium citrate. Clin Nephrol 2008; 69: 317-318.
9. Polaschegg HD. Catheter locking-solution spillage: theory and experimental verification. Blood Purif 2008; 26: 255-260.
10. Agharazii M, Plamondon I, Lebel M et al. Estimation of heparin leak into the systemic circulation after central venous catheter heparin lock. Nephrol Dial Transplant 2005; 20: 1238-1240.
11. European Community. Council Directive 93/42/EEC of 14 June 1993 Concerning Medical Devices. Article 1; (6 March 2011, date last accessed).
12. Polaschegg HD. Loss of catheter locking solution caused by fluid density. ASAIO J 2005; 51: 230-235.
13. Doorenbos CJ, Van den Elsen-Hutten M, Heuven MJ et al. Estimation of trisodium citrate (Citra-Lock) remaining in central venous catheters after the interdialytic interval. Nephrol Dial Transplant 2006; 21: 543-545.
14. Ash SR, Mankus RA, Sutton JM et al. Concentrated sodium citrate (23%) for catheter lock. Hemodial Int 2000; 4: 22-31.
15. Hofmeister F. Zur Lehre von der Wirkung der Salze. Zweite Mittheilung. Arch Exp Pathol Pharmakol 1888247-260.
16. Kunz W, Henle J, Ninham BW. 'Zur Lehre von der Wirkung der Salze' (about the science of the effect of salts): Franz Hofmeister's historical papers. Curr Opin Colloid Interface Sci 2004; 9: 19-37.
17. Willicombe MK, Vernon K, Davenport A. Embolic complications from central venous hemodialysis catheters used with hypertonic citrate locking solution. Am J Kidney Dis 2010; 55: 348-351.
18. Presson RG, Jr, Kirk KR, Haselby KA et al. Fate of air emboli in the pulmonary circulation. J Appl Physiol 1989; 67: 1898-1902.
19. Mermel LA, Allon M, Bouza E et al. Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis 2009; 49: 1-45.
20. Droste JC, Jeraj HA, MacDonald A et al. Stability and in vitro efficacy of antibiotic-heparin lock solutions potentially useful for treatment of central venous catheter-related sepsis. J Antimicrob Chemother 2003; 51: 849-855.
21. Aronson JK, Grahame-Smith DG. Clinical pharmacology. Adverse drug interactions. Br Med J 1981; 282: 288-291.
22. Bastani B. The myth of incompatibility of gentamicin and heparin revisited. J Nephrol 2011; 24: 192-195.
23. Robinson JL, Tawfik G, Saxinger L et al. Stability of heparin and physical compatibility of heparin/antibiotic solutions in concentrations appropriate for antibiotic lock therapy. J Antimicrob Chemother 2005; 56: 951-953.
24. Riley BB. Incompatibilities in intravenous solutions. J Hosp Pharm 1970; 28: 228-240.
25. Kanji S, Lam J, Johanson C et al. Systematic review of physical and chemical compatibility of commonly used medications administered by continuous infusion in intensive care units. Crit Care Med 2010; 38: 1890-1898.
26. Dotson B, Lynn S, Savakis K et al. Physical compatibility of 4% sodium citrate with selected antimicrobial agents. Am J Health Syst Pharm 2010; 67: 1195-1198.
27. Battistella M, Vercaigne LM, Cote D et al. Antibiotic lock: in vitro stability of gentamicin and sodium citrate stored in dialysis catheters at 37 degrees C. Hemodial Int 2010; 14: 322-326.
28. Nichols WW, O'Rourke MF.Nichols WW, O'Rourke MF. The nature of flow of a fluid. McDonald's Blood Flow in Arteries. London, UK: Edward Arnold, 1990, pp. 12-53.
29. Guntheroth WG, Luchtel DL, Kawabori I. Functional implications of the pulmonary microcirculation. An update. Chest 1992; 101: 1131-1134.
30. Stegmayr B, Forsberg U, Jonsson P et al. The sensor in the venous chamber does not prevent passage of air bubbles during hemodialysis. Artif Organs 2007; 31: 162-166.
31. Mehrishi S, Awan A, Mehrishi A et al. Pulmonary tumor microembolism. Hosp Physician 2004; 40: 23-30.
32. Akamatsu K, Tanaka Y, Tada K et al. Filtration of fresh frozen plasma used as substitution fluid in plasma exchange in order to remove microaggregates. Artif Organs 1990; 14: 419-435.
33. Clark AR, Burrowes KS, Tawhai MH. The impact of micro-embolism size on haemodynamic changes in the pulmonary micro-circulation. Respir Physiol Neurobiol 2011; 175: 365-374.
34. Malik AB. Pulmonary microembolism. Physiol Rev 1983; 63: 1114-1207.