Catheter lock solution is a solution put into catheters to fill the catheter when not in use, primarily to prevent clotting. Neutrolin is an anti-microbialcatheter lock solution developed by Cormedix/Cormedix GmbH. Neutrolin contains heparin and citrate (1000 U/mL and 3.5% respectively[1]), two compounds commonly used to prevent thrombosis and maintain catheter patency. Other brand names include Citra-Lock and Taurolock.
Neutrolin also contains taurolidine, an anti-microbial agent that has been shown to be safe and effective in preventing bacterial colonization of catheters.[2][3][4][5][6] No resistance to taurolidine has been observed to date.
To avoid the use of heparin in central venous catheters, citrate catheter locks were developed. Citrate solutions can be used as a catheter lock without any additives like antibiotic agents or antiseptic agents like taurolidine. Antibiotic catheter lock solutions could lead to antibiotic resistance and taurolidine has been associated with catheter-related clotting. Therefore it is necessary to mix taurolidine products with heparin to avoid catheter patency issues like thrombosis.[7] Heparin is an anticoagulant, and if used as a catheter lock solution it could leak into the blood circulation of the patient. Therefore it has been associated with catheter-related bleeding and heparin induced thrombocytopenia (HIT).[8][9]
Citrate catheter lock solutions are being used in three different concentrations – 4%, 30% and 46.7%. Citrate catheter lock solutions of 4% concentration have been recommended as best practice in a position statement of European Renal Best Practice guidelines, as published in 2010.[10]
The concentrations of 30% citrate and 46.7% citrate used as catheter lock solution have been associated with lower rates of catheter related infection and a decrease of the use of thrombolytic agents like urokinase or tissue plasminogen activator (t-PA).[11][12]
^Solomon, L.R.; et al. (June 2010). "A Randomized Double-Blind Controlled Trial of Taurolidine-Citrate Catheter Locks for the Prevention of Bacteremia in Patients Treated with Hemodialysis". American Journal of Kidney Diseases. 55 (6): 1060–1068. doi:10.1053/j.ajkd.2009.11.025. PMID20207458.
