Lock solutions in parenteral nutrition
Ingredients, efficacy, recommendations
There are many reasons why patients might become dependent on partial or total parenteral nutrition (PPN/TPN):
- short bowel syndrome
- malfunctions of the GI (gastro-intestinal) tract
- critical diseases
- and others
This can affect elderly people as much as young adults, children, and even infants. Nutrients must then be administered through a central-venous catheter (CVC) implanted in the patient’s chest. While CVC systems can save lives, they also bear considerable risks. Therefore, we have developed specialised lock solutions to protect patients against catheter-related complications and infections.
TauroLock™ for patients in need of parenteral nutrition
Vascular access devices (VAD) such as catheters can quickly turn into a breeding ground for germs. This poses a particular threat to people who already suffer from other medical problems: In fact, catheter-related infections are a common cause of death among TPN patients? (Sun Y, Wan G, Liang L (2020): Taurolidine lock solution for catheter-related bloodstream infections in pediatric patients: A meta-analysis. PLoS ONE 15(4): e0231110.) TauroLock™ lock solutions are designed to make the process of parenteral nutrition as safe and convenient as possible. All of our products contain one main ingredient:
The antimicrobial agent taurolidine kills more than 500 types of germs.
Apart from infections, patients must also avoid occlusions. Contact with blood, especially at the tip of the catheter, can lead to severe blood clotting. We offer lock solutions with anticoagulant or fibrinolytic substances to maintain an adequate flow rate: citrate, heparin, and/or urokinase.
All ingredients named above have been approved and recommended in current guidelines (GPOH, ESPEN, GaVeCeLT, DGE, and other national guidelines).
Please note that all TauroLock™ products are to be administered by trained staff with medical expertise and experience. On this premise, we advise the following procedure:
1. Before parenteral nutrition:
- Remove TauroLock™/ NutriLock™/ TauroLock™-Hep100/ TauroLock™-U25.000 and residual blood from the VAD.
- Once the VAD no longer contains any lock solution, flush all lumens with 10 ml of saline and a syringe according to the push-pause technique.
- Start parenteral nutrition.
2. After parenteral nutrition:
- Flush both lumens with 10 ml of saline according to the push-pause technique.
- Gently tap the ampoule’s neck to remove the lock solution.
- Tilt the ampoule so that you can see a white dot on top and quickly break off the neck.
- When using TauroLock™-U25.000:
Reconstitute the urokinase that is delivered in a separate vial with TauroLock™ withdrawn from the ampoule. TauroLock™-U25.000 must be used immediately after reconstitution. - Draw the TauroLock™ solution from the ampoule into a sterile syringe.
3. In-between treatment sessions:
- To ensure the solution’s prophylactic efficacy, slowly instil a volume sufficient to fill the entire lumens of the device.
- You can check the proper filling volume of each lumen as indicated on the device or based on the manufacturer’s instructions.