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Central venous catheters and catheter locks in children with cancer: A prospective randomized trial of taurolidine versus heparin
Author(s) -
Handrup Mette Møller,
Møller Jens Kjølseth,
Schrøder Henrik
Publication year - 2013
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.24482
Subject(s) - medicine , catheter , confidence interval , surgery , central venous catheter , incidence (geometry) , bacteremia , bloodstream infection , heparin , lock (firearm) , mechanical engineering , physics , microbiology and biotechnology , optics , biology , engineering , antibiotics
Background To determine if the catheter lock taurolidine can reduce the number of catheter‐related bloodstream infections (CRBSI) in pediatric cancer patients with tunneled central venous catheters (CVC). Procedure During a study period of 34 months, 129 newly placed tunneled CVCs in 112 patients were randomly assigned to standard lock with heparin solution or experimental lock with a taurolidine solution ( ClinicalTrials.gov Identifier NCT00735813). Results Sixty‐five CVCs were included in the standard group and 64 CVCs in the experimental group. The groups were comparable regarding patients' characteristics. A total number of 72 bloodstream infections of which 33 were CRBSIs were observed during 39,127 CVC‐days. A lower rate of CRBSI (0.4 per 1,000 CVC‐days) was observed in the experimental arm compared with the standard arm (1.4 per 1,000 CVC‐days, incidence rate ratio (IRR) = 0.26; 95% confidence interval (CI) 0.09–0.61; P = 0.001). A lower rate of total bloodstream infections (1.2 per 1,000 CVC‐days) was also observed in the experimental arm compared with the standard arm (2.5 per 1,000 CVC‐days, IRR = 0.49; 95% CI 0.29–0.82; P = 0.004). Median interval from catheter insertion until first CRBSI was significantly lower in the standard group (156 days, range 12–602) compared with the experimental group (300 days, range 12–1,176; P = 0.02). Premature removal of the CVC due to infection and overall CVC survival were similar in the two study groups. Conclusion Locking of long‐term tunneled CVC with taurolidine significantly reduces catheter‐related bloodstream infections in children with cancer. Pediatr Blood Cancer 2013;60:1292–1298. © 2013 Wiley Periodicals, Inc.