Abstract
Intravenous catheter-related bloodstream infections are a cause of remarkable problems. Catheter lock solutions are used to keep catheter patency and prevent catheter-related bloodstream infections. The leakage of catheter lock solution to the bloodstream raises toxicity concerns. Plasma-treated liquids carry the potential to act as catheter lock solutions by virtue of their strong antimicrobial effects. The present study investigates the tolerance of the proposed solution in vitro and in vivo. N-acetylcysteine (NAC) solution was treated with atmospheric-air DBD plasma and antimicrobial assays were performed. The cytotoxicity of the plasma-treated NAC solution was evaluated on an EA.hy926 cell line. Intravenous administration of plasma-treated NAC solution in different doses was given to Sprague Dawley rats. One week after infusion with plasma-treated NAC solution, first, the blood samples were collected, and then liver, kidney, tail vein, heart, and lung tissue samples were collected from euthanized rats for histopathological examination. The cytotoxicity of plasma-treated NAC solution depended on plasma treatment time, contact time, and cell number. A strong antimicrobial effect with no cytotoxicity of plasma-treated NAC solution was observed in endothelial cells. Based on blood tests and histopathological examination, no signs of systemic toxicity were observed that can be correlated to the plasma-treated-NAC solution. This solution has the potential to be used as a catheter lock solution with strong antimicrobial properties, keeping catheter patency.
Highlights
Access to the vascular system is one of the most essential practices of modern medicine especially for hospitalized patients and 70% of them receive some type of catheter for vascular access [1,2]
NAC solution was treated with dielectric-barrier discharge (DBD) air plasma that was generated by a microsecond pulsed AC power supply, operated at 31.4 kV peak to peak voltage and 1.5 kHz frequency and 0.29 W/cm2 power distribution
NAC solution was observed as a strong and stable solution which retained its broadspectrum antimicrobial property over two years [18], making it eligible for storage and use during an extended period of time. Their strong antimicrobial effect is usually attributed to reactive oxygen species (ROS) and reactive nitrogen species (RNS) that are generated in it by plasma treatment
Summary
Access to the vascular system is one of the most essential practices of modern medicine especially for hospitalized patients and 70% of them receive some type of catheter for vascular access [1,2]. Intravascular catheters are devices that are used for vascular entry and comprise various devices such as ports, peripheral and midline venous catheters, central venous catheters (CVCs), and arterial catheters [2]. These devices serve several purposes including monitoring hemodynamic parameters of the patient, blood collection for diagnostic or prognostic tests, administration of intravenous fluids and medications, and linking patients to hemodialysis machines [3]. Catheter-related bloodstream infection (CRBSI) and central line-associated bloodstream infection (CALBSI). Are two different BSIs that are related to intravascular catheters [3,5]. CLABSI refers to the presence of BSI in patients who have
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