Estudio comparativo del sellado de catéteres con citrato trisódico o heparina sódica más gentamicina

Abstract

Placing a catheter in a central vein as vascular access for haemodialysis is a quick and safe alternative that can be used immediately and lets optimal blood flows be obtained. However, the use of catheters is not free from complications, causing high morbility and increasing the work load and economic cost. The colonization and formation of a film produced by bacteria (biofilm) are considered risk factors, both in infections related to the catheter and in intraluminal thrombosis. To reduce these complications, we used a catheter sealing protocol with a 5% heparin solution plus gentamicin. However, due to haemorrhagic complications, infections and a constant exposure of the patient to antibiotics, it was decided to change the protocol to a concentrated (46.7%) trisodium citrate solution because of its anticoagulant and antimicrobial properties. Our aim is to evaluate the implementation of a protocol with concentrated trisodium citrate for sealing catheters. The results obtained in this study are: important fall in the number of infections; less handling; less use of antibiotics, preventing the creation of resistance and sensitivities; adequate dialytic dose, reduction in economic cost of work load and in patient morbility.