General    What is TauroLock™? TauroLock™ is a catheter lock solution for tunneled and non-tunneled central venous catheters and port systems. It has to be instilled into the device lumens between treatments in order to make the internal flow passages resistant to clot formation and hostile to bacterial and fungal growth. What are the active ingredients of TauroLock™? TauroLock™ for prophylaxis against bacterial and fungal infections contains cyclo-taurolidine as an antimicrobial ingredient and citrate (4 %) to make the internal flow resistant to clot formation. Why should I use TauroLock™? For preventing infections in catheters and ports. Heparin only acts as an anticoagulant but not bactericidal. Due to this the contamination of the catheter with only one germ may lead to bacteraemia. Preventing a biofilm by the prophylactic use of TauroLock™ improves the patency of the catheter or port. What are the side-effects of TauroLock™? No topical or systemic side effects are known. If the product is quickly injected into the bloodstream mild hypocalcaemic symptoms (e.q. metallic taste) might occur. How to use TauroLock™? 1. Flush the device with 10 ml of saline. 2. Withdraw TauroLock™ from the container using an appropriate syringe (e.g. 10 ml). 3. Instill TauroLock™ into the access device in a quantity sufficient to fill the catheter lumen. Consult the manufacturer’s instructions for the specific filling volume. TauroLock™ will remain inside the access device until the next treatment. 4. Prior to initiation of the next treatment, TauroLock™ should be withdrawn from the catheters and discarded. What happens if TauroLock™ is injected into the patient? The half- life of the antimicrobial ingredient within the body is less than 30 minutes. It is metabolized into the naturally occurring amino acid taurine. No toxic effects are expected or reported after an accidental injection. What to do in case TauroLock™ cannot be aspirated from the catheter? TauroLock™ can be flushed slowly (adults: 1 mL per 5 sec; children aged >3 months: 1 mL per 10 sec) into the bloodstream of the patient without any risk. Is TauroLock™ approved? TauroLock™ is a CE-marked medical device. It is sold all over Europe. How can I order TauroLock™? Tauro-Implant GmbH, Winsen, is the exclusive distributor in Germany.For distributors in other countries please visit www.taurolock.com. What is the minimum order quantity of TauroLock™? TauroLock™ is sold in 3 mL ampoules (minimum quantity order = 10x10x5 ampoules), 5 mL ampoules (minimum quantity order = 50x10 ampoules and 10 mL vials (minimum quantity order = 4x100). TauroLock™-Hep100 is also available in 5 mL ampoules (minimum quantity order as above). TauroLock™-Hep500 is available in 5 mL ampoules and 10 mL vials (minimum quantity order as above). Are different formulations (products) available for patients with recurrent flow problems? Two ready-to use TauroLock™ solutions containing 100 IU/mL (TauroLock™-Hep100) or 500 IU/mL of heparin (TauroLock™-Hep500) as an additional antocoagulant are available. Can TauroLock™ be used for all types of catheters and ports? TauroLock™ was tested on different polyurethane and silicone catheters. No degradation of the catheter or port material was detected in long term tests. Why is the concentration of citrate only 4%? Isn´t a higher concentration better for anticoagulation? A concentration of citrate of 4 % is recommended by the FDA (USA). FDA urges hospital pharmacies and hemodialysis units across the U.S. to stop using a product with a higher citrate content (Tricitrasol, 46,7 %). In the Netherlands, Punt reported two similar cases of cardiac arrest following the injection of concentrated (30%) trisodium citrate (Punt CD, Boer WE, Cardiac arrest following injection of concentrated trisodium citrate, Clinical Nephrology 2008,69 (4), 317-318). How long is maximum dwell time of TauroLock™ within the catheter? The dwell time of TauroLock™is similar to the dwell time of heparin in the catheter due to a similar density of the products. This is in contrast to highly concentrated citrate solutions which continuously spill into the bloodstream. TauroLock™ remains stable within the catheter for at least three months. At the moment I use heparin as a lock solution. Can I change to TauroLock™ without any complications? Patency problems have been reported occasionally after the installation of TauroLock™ into catheters which had been locked with heparin before. The manufacturer therefore recommends the addition of 0,5 ml of heparin (5000 Units/ml) to TauroLock™ or the use of TauroLock™-Hep100 (oncology, TPN) or TauroLock™-Hep500 (dialysis). How can I prevent premixing of TauroLock™ and heparin? Two ready-to use TauroLock™ solutions containing 100 IU/mL (TauroLock™-Hep100) or 500 IU/mL of heparin (TauroLock™-Hep500) as an additional antocoagulant are available. When should I use TauroLock™ -Hep100 and when TauroLock™ -Hep500? TauroLock™ -Hep100 is the product of choice in pediatrics and oncology. TauroLock™ -Hep500 is the product of choice in dialysis to achieve high flows in critical patients. Can I use the TauroLock™ -locked catheter for extracting laboratory analysis (e.g. coagulation/clotting)? Yes, you can. Procedure: Aspirate and discard TauroLock™. Flush the catheter with 10 mL of saline. Remaining traces of citrate do not influence the test result since the test tubes for coagulation tests are containing 3,13% of citrate. This procedure is not allowed when using TauroLock™-Hep100 or TauroLock™-Hep500.