What is Citra-Lock™?
Citra-Lock™ is a catheter lock solution for central venous catheters and is used as a lock in the catheter between two treatments to keep the catheter open and unclotted. It is placed in the catheter after a treatment and it must be aspirated before the next treatment.
What is the main component of Citra-Lock™?
The main component is high concentrated tri sodium citrate. The solution is adjusted for pH.
Why should I use Citra-Lock™?
Citra-Lock™ is an anticoagulant and replaces heparin as a catheter lock. The two main problems using (heparine locked) central venous catheters are thrombosis and infection. It is proven in in vitro and in in vivo studies, as well as in clinical practice, that a high concentrated citrate solution like Citra-Lock™ has a broad spectrum antimicrobial and antiyeast activity. Citra-Lock™ even prevents formation of biofilm.
What are the side-effects of Citra-Lock™?
The clinical (harmless) side-effects which are described and mentioned from clinical practice are dysgesia and parathesias. These side-effects disappear over time and are a sign that the catheter lock volume was overdosed. Decreasing the volume with 0,1 mL for the next instillation will solve the problem in most cases. If the patient still complains, decrease the lock volume again with 0,1 mL, untill the the patient doen’t complain anymore.
What are the systemic-effects of Citra-Lock™?
If Citra-Lock™ is used according the instructions in volumes suitable to catheter lumens, there is no reason to expect systemic effects from such a small volume of citrate.
How is Citra-Lock™ used ?
After dialysis, first the catheter is flushed with saline (5 to 10 mL per lumen). Then, both lumens are instilled with Citra-Lock™. The lock has to be injected slowly to be placed effectively in the catheter lumen (this counts for any catheter lock, also for heparine). The volume is determined by the prescription of the catheter manufacturer.
What to do in-case Citra-Lock™ can’t be aspirated?
Citra-Lock can slowly be injected into the patient without any risk, because there is a decrease of the initial level of citrate (46,7%) in the interdialytic period, due to leakage and diffusion. This is described in several publications (see below). Therefore the concentration of the injected citrate is even more harmless. Citra-Lock™ has no systemic effects after injection (see question 5).
What is the pink coloration in the extensions of the catheter when using Citra-Lock™?
Pink coloration may be caused by blood residues mixing with Citra-Lock™.
Is Citra-Lock™ registered?
According European regulations Citra-Lock™ is CE-marked as a medical device class IIb. Therefore it can be sold in any country where CE-registration is approved. Some countries outside the EU also accept the CE mark.
How can I buy Citra-Lock™?
Our company has contracted several distributors. Citra-Lock™ is distributed worldwide.
What is the order quantity of Citra-Lock™?
Each box with Citra-Lock™ contains 20 vials.
Analyzing the pre dialysis blood sample of patients I find sometimes a hypernatraemia.
A pre dialysis blood sample showing an excessive hypernatraemia shows up when the catheter, previously locked with Citra-Lock™, wasn’t efficiently flushed with saline. Even very small remains will cause a disturbed outcome of a natrium analysis. To avoid this flush the catheter efficiently with saline and never use syringe or needle which was also used to aspirate the lock. The publication below describes a case of hypernatraemia in combination with Citra-Lock™