Department of Intensive Care, University Hospital Dijon Bourgogne, Dijon, France.
Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de Médecine Intensive-Réanimation, Lyon, France.
Hemodial Int. 2023 Jan;27(1):12-20. doi: 10.1111/hdi.13047. Epub 2022 Oct 6.
We conducted a systematic review of studies investigating lock solutions for use in non-tunneled hemodialysis catheters.
We searched PubMed and Cochrane databases from inception to June 11, 2021. Study inclusion criteria were: randomized trial or observational study, adults (>18 years), with acute kidney injury (AKI); and temporary non-tunneled catheters. We recorded bleeding events, catheter dysfunction and complications.
Of 649 studies identified, 6 were included (4 randomized, 1 non-randomized trial, 1 retrospective cohort study; sample sizes 78-1496 patients). Citrate was compared to heparin in 4 studies, to saline in 1, and ethanol versus saline in 1. Event-free survival of non-tunneled catheters did not differ between groups. Catheter-related infections and adverse events were less frequent with citrate locks, but reached statistical significance in only two studies.
Existing data are too heterogeneous to enable recommending one type of catheter lock over any other for non-tunneled hemodialysis catheters.
我们对研究非隧道式血液透析导管用封管液的研究进行了系统评价。
我们检索了 PubMed 和 Cochrane 数据库，检索时间截至 2021 年 6 月 11 日。研究纳入标准为：随机试验或观察性研究，纳入年龄>18 岁、伴有急性肾损伤（AKI）的患者；并使用临时非隧道式导管。我们记录了出血事件、导管功能障碍和并发症。
在 649 项研究中，有 6 项研究符合纳入标准（4 项随机试验、1 项非随机试验、1 项回顾性队列研究；样本量 78-1496 例）。4 项研究比较了柠檬酸封管液与肝素，1 项研究比较了柠檬酸封管液与生理盐水，1 项研究比较了乙醇与生理盐水。非隧道式导管的无事件生存率在各组之间无差异。只有两项研究的结果显示，柠檬酸封管液可减少导管相关性感染和不良事件的发生，但未达到统计学意义。
现有数据过于异质，无法推荐任何一种封管液优于其他封管液用于非隧道式血液透析导管。
