PMID- 36067590
OWN - NLM
STAT- MEDLINE
DCOM- 20221004
LR  - 20221020
IS  - 1532-1983 (Electronic)
IS  - 0261-5614 (Linking)
VI  - 41
IP  - 10
DP  - 2022 Oct
TI  - Taurolidine-related adverse events in patients on home parenteral nutrition 
      frequently indicate catheter-related problems.
PG  - 2178-2184
LID - S0261-5614(22)00269-2 [pii]
LID - 10.1016/j.clnu.2022.07.025 [doi]
AB  - BACKGROUND & AIMS: A catheter-related bloodstream infection (CRBSI) is a serious 
      complication of home parenteral nutrition (HPN) treatment. Despite taurolidine's 
      frequent use as catheter lock solution (CLS) to prevent CRBSIs and its presumed 
      favourable safety profile, data on taurolidine-related adverse events (AEs) and 
      the clinical implications thereof remain merely anecdotal. Aim of this study was 
      to explore taurolidine-related AEs in our large cohort of HPN patients and to 
      develop an algorithm on how to deal with these AEs in clinical practice. METHODS: 
      This retrospective cohort study comprised all adult HPN patients who used 
      taurolidine as a CLS between 2006 and 2021 at our national HPN referral centre. 
      Primary outcome was to identify taurolidine-related AEs. Secondary outcomes were 
      median time to a taurolidine-related AEs and development of a clinical algorithm. 
      A taurolidine-related AE was defined as an event that occurred directly after 
      instillation of taurolidine in the CVAD or at start of fluid/PN infusion. 
      RESULTS: In total, 470 patients used taurolidine during 700.232 catheter days. In 
      89 (19%) patients, 103 mild- to severe AEs related to taurolidine were observed. 
      Six patients developed an allergic reaction. Reported AEs compromised vascular 
      access device-related problems (group A) or taurolidine-related problems (group 
      B) in 53 (51%) and 50 (49%), patients, respectively. In groups A and B, 51 (85%) 
      and 21 (18%) patients presented with taurolidine infusion-related pain. Upon 
      rechallenge, 45 (85%) and 16 (32%) patients, respectively, successfully resumed 
      taurolidine locking without residual symptoms. CONCLUSION: In this study, use of 
      taurolidine as CLS was generally safe. Most reported AEs were vascular access 
      device-related, and the majority of symptoms concerned pain. Upon rechallenge, a 
      substantial number of patients, especially those in whom pain was the main 
      symptom, could resume CLS locking after addressing the underlying 
      catheter-related problem. Based on these results, we present a clinical algorithm 
      for patients with possible taurolidine-related symptoms.
CI  - Copyright (c) 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.
FAU - Korzilius, J W
AU  - Korzilius JW
AD  - Department of Gastroenterology and Hepatology, Radboud University Medical Centre, 
      Nijmegen, the Netherlands. Electronic address: julia.korzilius@radboudumc.nl.
FAU - Gillis, V E L M
AU  - Gillis VELM
AD  - Department of Gastroenterology and Hepatology, Radboud University Medical Centre, 
      Nijmegen, the Netherlands.
FAU - Wouters, Y
AU  - Wouters Y
AD  - Department of Gastroenterology and Hepatology, Radboud University Medical Centre, 
      Nijmegen, the Netherlands.
FAU - Wanten, G J A
AU  - Wanten GJA
AD  - Department of Gastroenterology and Hepatology, Radboud University Medical Centre, 
      Nijmegen, the Netherlands.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20220731
PL  - England
TA  - Clin Nutr
JT  - Clinical nutrition (Edinburgh, Scotland)
JID - 8309603
RN  - 0 (Thiadiazines)
RN  - 1EQV5MLY3D (Taurine)
RN  - 8OBZ1M4V3V (taurolidine)
SB  - IM
MH  - Adult
MH  - *Catheter-Related Infections/diagnosis
MH  - *Central Venous Catheters/adverse effects
MH  - Humans
MH  - Pain/complications
MH  - *Parenteral Nutrition, Home/adverse effects/methods
MH  - Retrospective Studies
MH  - Taurine/analogs & derivatives
MH  - Thiadiazines
OTO - NOTNLM
OT  - Adverse event
OT  - Algorithm
OT  - Home parenteral nutrition
OT  - Intestinal failure
OT  - Taurolidine
OT  - Thrombosis
COIS- Conflict of interest None.
EDAT- 2022/09/07 06:00
MHDA- 2022/10/05 06:00
CRDT- 2022/09/06 18:17
PHST- 2022/05/30 00:00 [received]
PHST- 2022/07/01 00:00 [revised]
PHST- 2022/07/09 00:00 [accepted]
PHST- 2022/09/07 06:00 [pubmed]
PHST- 2022/10/05 06:00 [medline]
PHST- 2022/09/06 18:17 [entrez]
AID - S0261-5614(22)00269-2 [pii]
AID - 10.1016/j.clnu.2022.07.025 [doi]
PST - ppublish
SO  - Clin Nutr. 2022 Oct;41(10):2178-2184. doi: 10.1016/j.clnu.2022.07.025. Epub 2022 
      Jul 31.