Catheter lock solutions to prevent CVAD-related infection

Demand for vascular access devices (VADs) to meet the clinical needs of patients has increased dramatically in recent years, with a disproportionate increase in the numbers of patients requiring a central venous access device (CVAD) (Gabriel, 2015; Ray-Barruel and Rickard, 2015). This increase is linked not only to the ageing population and associated comorbidities that come with longevity, but also to the increasing range of parenteral therapies available to support patients, as well as the improved range and quality of CVADs (Ray-Barruel and Rickard, 2015; NHS England and NHS Improvement, 2019).

The insertion of a CVAD will require the skin to be punctured/cut. Once the skin is broken, an entry point for pathogens into the body is created. If that broken skin is part of a tract into a blood vessel, ie a cannulation site, bacteria can gain direct entry into the patient's bloodstream (Gabriel, 2015). Infections can also result from biofilm, which develops on the material of CVADs, with the potential to lead to catheter-related bloodstream infections (CRBSIs) (Srejic, 2016). The challenge of parenteral therapy is to minimise the risk of infusion-related infections for patients. Prevention is the key, not relying on antibiotics to solve the problem that treatment has initiated.