TauroLock™ is a catheter lock solutions for tunneled and non-tunneled vascular access and port systems to prevent catheter associated infections and catheter flow challenges.
TauroLock™ lock solutions contain 4 % citrate for the maintenance of catheter patency and taurolidine as an antimicrobial ingredient. In addition to taurolidine and 4 % citrate, TauroLock™-HEP100 contains 100 IU/ml heparin to improve patency. TauroLock™-HEP-500 contains 500 IU/ml heparin. Тhe most effective prophylaxis against catheter occlusion is ensured with the regular use of TauroLock™-U25.000, which contains 25,000 IU urokinase (5,000 IU/ml), taurolidine, and 4 % citrate. This combination reduces flow problems in the catheter substantially (see recommendations for lock solutions in dialysis). Which catheter lock solution will prove most advantageous depends on the patient’s individual situation. Alternating use (e.g. TauroLock™-HEP500, TauroLock™-U25.000) is feasible.
Heparin and 4 % citrate only have anticoagulant effects, but no bactericidal properties. Consequently, contamination of the catheter can lead to bacteremia. TauroLock™ lock solutions are used to prevent both infections and occlusions in catheter and port systems. Prophylactic use of TauroLock™ solutions prevents the formation of biofilm and thus maintains the flow rate in the catheter or port. The fibrinolytic activity of TauroLock™-U25.000 further improves patency by dissolving already formed clots.
A citrate concentration of 4 % is recommended by US regulatory authorities and others.
1. The FDA issued an advisory in the year 2000, not to use a product with a high citrate content. Lock solutions of this type had to be recalled from the US market. Their use is no longer approved. Best practise guidelines (e.g. KDOQI) also recommend 4% citrate.
2. Likewise, over-instillation of less than 1 ml per lumen of a 30 % citrate solution induced transient cardiac arrest in two cases in the Netherlands (Punt et al. Clinical Nephrology 2008. DOI: 10.5414/cnp69317).
3. A high citrate content (46.7 %) can also lead to embolic events which might be triggered by protein precipitation (Willicombe et al. American Journal of Kidney Diseases 2010. DOI: 10.1053/j.ajkd.2009.06.037 / Schilcher et al. Nephrol Dial Transplant 2012. DOI: 10.1093/ndt/gfs048).
The effect of TauroLock™ solutions on various catheter materials (polyurethane, silicone) has been investigated. All types of catheters remain undamaged, even in long-term tests.
Current findings show that a heparin 5,000 IU/ml solution can be replaced by TauroLock™-HEP500 without any issues. Hence, the use of heparin can be reduced drastically. TauroLock™-HEP500 is the product of choice in dialysis, whereas TauroLock™-HEP100 is used primarily in haematology/oncology or with paediatric patients.
