POS-624 ROLE OF GENTAMYCIN LOCKING SOLUTION IN THE PREVENTION OF CRBSI

Abstract

CRBSI is one of the most important complications of using Dialysis Catheter as a means of vascular access in haemodialysis. Various catheter locking solutions have been used to prevent this complication. The study aimed to assess the effectiveness of Gentamycin as a locking solution for the prevention of CRBSI in maintenance hemodialysis patients. This was a randomised controlled study which included all the patients of ESRD who required uncuffed catheter as a means of temporary vascular access. The patients of AKI , those having fever or source of infection anywhere in the body were excluded. Gentamycin locking solution was prepared by mixing 2 ml of Gentamycin (80 mg) + 2 mL of normal saline + 1 mL of heparin (5000 IU∖mL), with effective concentration of 16 mg/ml of gentamycin and was used in each of the catheter hub at the end of dialysis in the cases labelled as group 1 whereas in the control group, labelled as group 2, only heparin (1000/ml) was used. To minimise the duration of use of dialysis catheter, emphasis was given to get AVF constructed at the earliest. The primary goal was development of CRBSI and the secondary goals were maturation of AVF, complications of Gentamycin, shift to other modality of RRT or vascular access. Total of 100 patients were included in the study period of 1 year. There were no significant differences in the baseline characteristics. The rate of CRBSI in the group 1 and 2 were four (8%) and six (12%), which were statistically insignificant (P=0.50). The number of days for the development of CRBSI following catheter insertion in group 1 & 2 were 7.0 +5.568 and 7.83+ 8.35 days (P=0.88).In 86 patients (42 in group 1 & 44 in group 2) AVFs matured , seven patients had removal of the catheter because of withdrawal of therapy, three patients had TCC insertion, two patients were lost to follow up and two patients died. No complication related to the use of Gentamycin was observed. Gentamycin does not have any beneficial effect in preventing CRBSI through uncuffed hemodialysis catheter if early construction of AVF is the routine policy in the dialysis unit.