Catheter lock

Anyone that uses catheter for hemo, what are you using to pack it with? Is anyone using antibiotic/heparin mixture?

Just Heparin here.

Marty

Everything I read about using a combination of heparin and gentamicin is positive. I would just like to hear from someone else that is doing it.

http://www.nature.com/ki/journal/v66/n2/abs/4494667a.html

I have known patients who took gentamicin for infections and developed hearing loss and severe balance problems because they had too high a blood level of gentamicin. These complications affects those patients’ quality of life.

I’d want to keep on top of the gentamicin levels in my body and to ask the doctor how high the risks of these complications are if the gent levels are at the level they are in your body. I’d also want to know if using this antibiotic could have a negative effect on how antibiotics will work if you develop a disease requiring antibiotic treatment. There are “super bugs” out there that can be deadly.

[QUOTE=Beth Witten MSW ACSW;12283]I have known patients who took gentamicin for infections and developed hearing loss and severe balance problems because they had too high a blood level of gentamicin. These complications affects those patients’ quality of life.

I’d want to keep on top of the gentamicin levels in my body and to ask the doctor how high the risks of these complications are if the gent levels are at the level they are in your body. I’d also want to know if using this antibiotic could have a negative effect on how antibiotics will work if you develop a disease requiring antibiotic treatment. There are “super bugs” out there that can be deadly.[/QUOTE]

My partner is just using Heparin 5000 USP. Have been doing it for about five years. They had us try 1000 USP but found that when I extracted the heparin before treatments. the lower dosage caused a larger clot in the cathater line so we went back to 5000 USP.

HemoHelper

[quote=Beth Witten MSW ACSW;12283]I have known patients who took gentamicin for infections and developed hearing loss and severe balance problems because they had too high a blood level of gentamicin. These complications affects those patients’ quality of life.

I’d want to keep on top of the gentamicin levels in my body and to ask the doctor how high the risks of these complications are if the gent levels are at the level they are in your body. I’d also want to know if using this antibiotic could have a negative effect on how antibiotics will work if you develop a disease requiring antibiotic treatment. There are “super bugs” out there that can be deadly.[/quote]
You are right. These are some of the questions I had for our nephrologist prior to starting on this.

We are mixing 0.2cc gentamicin (40mg/ml) with 2.8cc heparin (5000u/ml). In trials, catheter infection rates are practically nonexistant.

At this level, the exposure to gentamicin is small. Plus most of it stays in the catheter and is removed daily. The small amount that is introduced into the bloodstream is removed by dialysis.

All this sounds great in theory. I have lived long enough to know that real life can be much different than theory. I was hoping to find others using this technique. It can’t hurt to stay in touch and discuss any problems that may crop up.

Our clinic did a year trial of Gent/Heparin Lock for all of our catheters. We teamed up with a pharmacist to come up with the proper formula mixture of the Gent/Heparin/Sterile Water. Over the year time we had one cathether related Bacteria episode. There were no episodes of hearing loss, vertigo, or super infections from the Gent. The previous post is correct in that such a small amount of Gent is used and is is diluted. Only the amount equal to the length of the catheter is used and Gent is dialyzed out.
Good Luck.

After the trial did you continue to use the Gent?