4% Tetrasodium EDTA to Prevent Central Venous Access Device–Associated Complications

Can the use of 4% tetrasodium EDTA locking fluid decrease rates of central venous access device (CVAD) complications in adults hospitalized in intensive care units?In this triple-blind, multicenter, cluster-randomized crossover study of 1468 patients, the incidence of a composite end point of CVAD-associated bloodstream infection, catheter occlusion requiring alteplase use, and catheter removal due to occlusion was 13.1 per 1000 catheter-days (74 events) among patients randomized to receive 4% tetrasodium EDTA locking fluid vs 19.9 per 1000 catheter-days (126 events) in the control group receiving saline or 4% citrate for hemodialysis lines, a statistically significant difference.In an adult critical care setting, use of 4% tetrasodium EDTA as a locking fluid reduced a composite outcome of CVAD complications compared with control.

Corresponding Author: Steven Reynolds, MD, Intensive Care Unit, Royal Columbian Hospital, 330 Columbia St, New Westminster, BC V3L 3W7, Canada (sreynolds.md@gmail.com).

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