Abstract
OBJECTIVE: Chronic intestinal failure is a devastating chronic medical condition, which requires central venous access for parenteral nutrition infusion. The presence of a central venous line is associated with an increased risk of bloodstream infection and thrombosis. Currently, the heparin lock is the most used catheter lock, but still has risks for line infection. The 4% tetrasodium EDTA catheter lock (KiteLock™) solution, has demonstrated a decrease in infection and thrombosis risk, but requires extra steps for the preparation and infusion. The objective of this study was to evaluate the patients ease-of-use and acceptability of the new KiteLock solution in the home parenteral nutrition (HPN) patients. METHODS: This prospective, open-label, single-center study evaluated patient acceptability of tetrasodium EDTA (KiteLock) in HPN. Patients were contacted four times, beginning with an instructional visit by the HPN nurse. They then completed three 30-day phases: standard heparin/saline flush, tetrasodium with withdrawal (when feasible), and tetrasodium EDTA. During the final week of each phase, patients completed a phone survey and questionnaire with the HPN nurse. RESULTS: Of the 21 patients enrolled, 14 completed the study. Seven did not: two withdrew due to time constraints, two found KiteLock difficult to infuse, and three had incomplete data. Among those who competed the study, some reported reduced ease-of-use with KiteLock (1 hard to open, 5 difficulties withdrawing, 1 overall difficulty), though most still rated it easy or very easy. Three patients continued to find it more difficult by study end. No adverse effects were reported. Preparation time decreased over time as patients adapted. Initial satisfaction with KiteLock was lower (50% find it neutral), but improved with familiarity, becoming comparable to heparin with 12 patients satisfied (N = 14). CONCLUSIONS: KiteLock solution is well accepted by the patient or caregiver, despite involving more steps to use it.