FAQ
TauroLock™ is a catheter lock solution for tunnelled and non-tunnelled vascular access and port systems for the prevention of catheter-associated infections and catheter flow problems.
TauroLock™ contains (cyclo)-taurolidine as an antimicrobial ingredient and 4% citrate for maintaining patency.
TauroLock™-Hep100 contains additional 100 IU/mL heparin to improve the patency. TauroLock™-Hep500 contains 500 IU/mL heparin.
The most intense prophylaxis against catheter occlusion is attained through the regular use of TauroLock™-U25.000 (containing 25.000 IU urokinase, 5.000 IU/mL). This reduces flow problems in the catheter substantially, see recommendation on the page “Lock solutions in dialysis”.
The decision as to which catheter lock solution is most advantageous depends on the situation of the individual patient. Alternating use (e.g. TauroLock™- Hep500, TauroLock™- U25.000) is feasible.
To prevent infections in catheter and port systems. Heparin and 4% citrate only have an anticoagulant effect, but no bactericidal properties. Consequently, contamination of the catheter can lead to bacteraemia. Prophylactic use of TauroLock™ prevents the formation of a biofilm and thus improves the patency of the catheter and/or port.
No topical or systemic side effects of the ingredients are known. Due to the citrate content (citrate content: 4%), overly rapid application into the bloodstream can lead to mild hypocalcaemic effects (e.g. metallic taste).
- Rinse the vascular access system with at least 10 mL of physiological saline in compliance with the “Pulsatile Flush Method” (Goossens, 2015).
- Then use a suitable syringe to remove TauroLock™ from the container.
- Instill a sufficient amount of TauroLock™ into the vascular access system to fill the hollow space of the catheter. The specific filling volume is stated in the instructions of the manufacturer.
- TauroLock™ remains inside the access system until the next treatment.
- TauroLock™ should be aspirated before the start of the next treatment - to the extent this is reasonable and possible.
- Rinse the vascular access system with 10 mL of physiological saline.
The antimicrobial ingredient of the lock solution is degraded extremely quickly in the body. The degradation produces taurine, an amino acid that is naturally present in the body. Accordingly, no harmful effects are known or expected to result from inadvertent instillation.
TauroLock™ can be injected slowly into the bloodstream without any risk (i.e. 1 mL per sec. in adults and 1 mL per 5 sec. in paediatric patients). If TauroLock™ supplemented with heparin is used, it is the responsibility of the user to assess the risk of the systemic administration of heparin.
TauroLock™ is approved as a medical device with CE registration since 2004 and can be marketed throughout Europe.
The product is distributed in Germany by Tauro-Implant GmbH, Winsen exclusively (phone: +49 (0)4171 – 890810 / Email:info@tauro-implant.de).
In Austria, please contact Crosstec GmbH, Vienna (phone: +43 – (1) – 31031000 / Email:office@crosstec.eu) and in Switzerland please contact MCM-Medsys AG in Solothurn (phone: +41 – (0) 34 – 4481414 / Email: info@mcm-medsys.ch).
Please contact the distributor in your country (see www.taurolock.com) or write to infos@tauropharm.de.
Various package sizes of TauroLock™ catheter lock solutions are available.
The effect of TauroLock™ on various catheter materials (polyurethane, silicone) has been investigated. All types of catheters remain undamaged even in long-term tests.
A citrate content of 4% is recommended by the US regulatory authorities and others. In the context of one case of fatality, the FDA issued an advisory not to use a product with a higher citrate content (Tricitrasol, 46.7 %). Lock solutions of this type had to be recalled from the US market. Their use is no longer approved. 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 CD, Boer WE, Cardiac arrest following injection of concentrated trisodium citrate, Clinical Nephrology 2008, 69 (4), 317-318). A high citrate content (46.7%) can also lead to embolic events which might be triggered by protein precipitation (Davenport A , Willicombe MK, Vernon K, Embolic complications from central venous hemodialysis catheters used with hypertonic citrate solution, American Journal of Kidney Diseases, 2010, 55, 348-351 / Schilcher G, Scharnagl H, Horina JH, Ribitsch W, Rosenkranz AR, Stojakovic T and Polaschegg H-D, Trisodium citrate induced protein precipitation in haemodialysis catheters might cause pulmonary embolism, Nephrol Dial Transplant (2012) 0: 1–5).
The experience accumulated thus far with the heparin-containing TauroLock™ products shows that, for example in dialysis, a heparin 5,000 IU/mL solution can be replaced by the TauroLock™-Hep500 solution without any problems, i.e. the use of heparin can be reduced drastically. Accordingly, TauroLock™-Hep500 is the product of first choice in dialysis, whereas TauroLock™-Hep100 is used primarily in vascular access in haematology/oncology or in paediatric patients. TauroLock™-Hep100 or Hep500 needs to be aspirated before the next dialysis treatment.
The experience accumulated thus far with the heparin-containing TauroLock™ products shows that, for example in dialysis, a heparin 5,000 IU/mL solution can be replaced by a TauroLock™-Hep500 solution without any problems, i.e. the use of heparin can be reduced drastically. Accordingly, TauroLock™-Hep500 is the product of first choice in dialysis, whereas TauroLock™-Hep100 is used primarily in vascular access in haematology/oncology or in paediatric patients. TauroLock™-Hep100/-Hep500 needs to be aspirated before the next dialysis or treatment.
Yes! After aspiration and disposal of the TauroLock™ (without heparin), rinse the catheter with saline. Then you can take the coagulation test sample. Even if minor traces of citrate remain in the catheter, this would not have an effect on the result of the analysis since the sampling tube is filled with a 3.13% citrate solution. In contrast, despite intensive rinsing, locking with heparin leads to relevant contamination of the blood sample that must be seen as an extreme problem especially with regard to the testing of the INR as part of the monitoring of patients receiving Marcumar™ therapy (possible under-dosing by false prolongation of the INR). Therefore, peripheral blood needs to be obtained in the presence of a heparin lock.