Catheter lock solution is a solution put into

catheter In medicine, a catheter ( ) is a thin tubing (material), tube made from medical grade materials serving a broad range of functions. Catheters are medical devices that can be inserted in the body to treat diseases or perform a surgical procedure. ...

s to fill the catheter when not in use, primarily to prevent

clotting Coagulation, also known as clotting, is the process by which blood changes from a liquid to a gel, forming a blood clot. It results in hemostasis, the cessation of blood loss from a damaged vessel, followed by repair. The process of coagulation ...

. Neutrolin is an

anti-microbial An antimicrobial is an agent that kills microorganisms (microbicide) or stops their growth (bacteriostatic agent). Antimicrobial medicines can be grouped according to the microorganisms they are used to treat. For example, antibiotics are used aga ...

lock solution developed by Cormedix/Cormedix GmbH. Neutrolin contains

heparin Heparin, also known as unfractionated heparin (UFH), is a medication and naturally occurring glycosaminoglycan. Heparin is a blood anticoagulant that increases the activity of antithrombin. It is used in the treatment of myocardial infarction, ...

and

citrate Citric acid is an organic compound with the formula . It is a colorless weak organic acid. It occurs naturally in citrus fruits. In biochemistry Biochemistry, or biological chemistry, is the study of chemical processes within and relati ...

(1000 U/mL and 3.5% respectively), two compounds commonly used to prevent

thrombosis Thrombosis () is the formation of a Thrombus, blood clot inside a blood vessel, obstructing the flow of blood through the circulatory system. When a blood vessel (a vein or an artery) is injured, the body uses platelets (thrombocytes) and fib ...

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. 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. 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). 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. 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). Taurolidine/heparin (Defencath) was approved for medical use in the United States in November 2023.

References

{{Authority control Antimicrobials