Catheter locking solutions
Topic Status Complete
Non antibiotic antimicrobial anticoagulant catheter locking solutions for the prevention of catheter related complications
Outcome of the appraisal
The evidence partially supports the use of non-antibiotic, antimicrobial, anticoagulant catheter locking solutions for the prevention of catheter-related complications.
TauroLock should be considered for children receiving home parenteral nutrition, chemotherapy or stem cell transplantation and for adults receiving home parenteral nutrition or dialysis. TauroLock is associated with fewer catheter-related bloodstream infections compared with either saline or heparin in these populations. Economic modelling suggests that TauroLock is cost effective in these comparisons and populations.
The evidence does not support the case for routine adoption of TauroLock-U25.000. There is greater uncertainty in the evidence for KiteLock 4%, and, while it shows promise, the current evidence is insufficient to support routine adoption.
HTW recommends that data are collected on clinical outcomes and local experience when devices are used.
Why was this topic appraised?
Central venous catheters are used to deliver many different therapies, such as chemotherapy, parenteral nutrition and haemodialysis. However, their use can lead to serious complications including infections and blockages. Catheter locking solutions may be used to fill the empty space in a catheter between treatments and are one of several available strategies aimed at reducing the risk of catheter-related complications.
Current NICE guidelines recommend that catheters are locked with saline and recommend against the routine use of antibiotic locks. It has been suggested that non-antibiotic catheter locking solutions that have antimicrobial and anticoagulant properties may further reduce the incidence of catheter-related complications, which would benefit patients and reduce costs to the NHS.
This topic was suggested by the Managing Director of ScottMed Distribution UK Ltd.
Plain language summary
A catheter is a soft, flexible, and hollow medical tube that is inserted into the body to carry fluids in or out. Catheters can be inserted into veins to deliver medicines, blood, and fluids, or into the bladder to carry out urine. It is important that catheters are clean and well maintained. Catheter related complications such as catheter related bloodstream infections occur when the presence of bacteria builds up in the catheter and passes into the patient.
Methods of preventing bacteria from developing in catheters include locking systems. These are fluid solutions that contain ingredients that prevent bacterial build up. Different combinations of ingredients are used to combat the different causes of bacterial build up. Non-antibiotic, antimicrobial and anti-coagulant catheter locking solutions use a combination of ingredients that are not antibiotic but do help to prevent the growth of microbes and the clotting of blood vessels.
Health Technology Wales looked for evidence on non-antibiotic, antimicrobial and anti-coagulant catheter locking solutions for the prevention of catheter related complications. The evidence partially supports their use, depending on the type of lock and the setting where it is used.
Topic Exploration Report
TER486 02.2024
Evidence Appraisal Review
EAR062 11.2024
Guidance
GUI062 11.2024
Health Technology Wales Partners
