Intravascular (IV) catheters are essential for patient management in both critical and routine care environments at hospitals. Currently, IV catheter infection is controlled by cleaning the access site with antibiotics, disinfectants, and antiseptic catheter coatings. However, these methods are only partially successful in preventing overt abscess at the insertion site and even with such antiseptic coatings, bacterial adhesion, growth, and bacterial biofilm formation on the outer catheter surface remains common. The other common risk with IV catheters is clot formation on the distal end of the lumen, which is usually prevented by injecting an anti-coagulant, heparin or citrate solution, into the catheter as a lock solution.
an estimated 80,000 catheter related blood stream infections (CR-BSIs) occurring in just intensive care patients in the United States each year
> 20,000 deaths and increased health care costs of ca. $2.3 billion per year
overall, estimated rate of CR-BSIs is approx. 250,000 annually, with a staggering mortality rate of 12-25%
Microbial biofilm formation on the inner/outer catheter surfaces is particularly problematic, as antibiotics and other antimicrobial agents within lock solutions cannot diffuse through the walls of the catheters. These “biofilms” are a nidus for infection and reducing their prevalence would significantly reduce the rate of CR-BSIs. NOTA’s approach overcomes many shortcomings of antibiotics by using NO releasing agents that allow for a controlled time release of NO.
Nitric oxide is a potent, natural antimicrobial and antiplatelet agent in our bodies that is used by the immune system to fight infection. Because NO is a gas, it can diffuse through the wall of common IV catheter materials providing effective bactericidal protection on both the outside surface as well as the inside of the catheter. The NO released from the catheter lock solution can also inhibit platelet activation, preventing clot formation. and since the lifetime of NO in blood is < 1 s, at appropriate doses, cytotoxicity is not possible.
NOTA has devised new lock solution reagent formulations that release NO over extended time periods. Antimicrobial testing of catheters filled with these new lock solutions have demonstrated excellent antimicrobial and anti-clotting activities when employed within different types of IV catheter materials (e.g., polyurethane, silicone rubber, etc.).