# Rabbit Hole: Citrate **URL:** \ **Category:** General\ **Created:** [February 21, 2026, 9:52pm UTC](http://forum.0xdbfb7.com/t/rabbit-hole-citrate/387 "2026-02-21T21:52:26Z")\ **Posts on this page:** 1\ **Page:** 1
**Author:** ![0xDBFB7](http://forum.0xdbfb7.com/user_avatar/forum.0xdbfb7.com/0xdbfb7/32/7_2.png) [@0xDBFB7](http://forum.0xdbfb7.com/u/0xDBFB7)\ **Post date:** [February 21, 2026, 9:52pm UTC](http://forum.0xdbfb7.com/t/rabbit-hole-citrate/387/1 "2026-02-21T21:52:26Z")
> Recently, trisodium citrate has also been used as a locking agent in vascath and haemodialysis lines instead of heparin due to its lower risk of systemic anticoagulation.[[8]](https://en.wikipedia.org/wiki/Trisodium_citrate#cite_note-8) [https://en.wikipedia.org/wiki/Trisodium\_citrate](https://en.wikipedia.org/wiki/Trisodium_citrate) > Locking is defined as the injection of a limited volume of a liquid following the catheter flush, for the period of time when the catheter is not used, to prevent intraluminal clot formation and/or catheter colonization. > [https://pmc.ncbi.nlm.nih.gov/articles/PMC4446496/](https://pmc.ncbi.nlm.nih.gov/articles/PMC4446496/) > some are even approved for the high pressure of CT-power injection. Also, almost all totally implantable venous access devices (TIVADs) or so called ports, in the marketplace, are power-injectable nowadays [[9](https://pmc.ncbi.nlm.nih.gov/articles/PMC4446496/#B9)]. My god. Nurses must have _so much expertise_. > Power Injectors have embedded safety features which automatically reduce the contrast administration flow rate when they reach the **300 psi threshold.** > [https://www.med.unc.edu/pediatrics/cccp/wp-content/uploads/sites/1156/2025/08/CT-PIV-Guidelines-06Aug25.pdf](https://www.med.unc.edu/pediatrics/cccp/wp-content/uploads/sites/1156/2025/08/CT-PIV-Guidelines-06Aug25.pdf) > - _Sepsis_: Using aseptic technique during loading/emptying the left over contrast and/or saline, preferred use of pre-filled syringes, and hand hygiene can prevent sepsis. In a study, double-syringe injectors used with disposable or prefilled contrast agent syringes ensured hygienic conditions in routine clinical practice. The organisms evaluated in this study were coagulase-negative staphylococci, micrococcus, and bacillus species.[[22](https://pmc.ncbi.nlm.nih.gov/articles/PMC4329682/#ref22)] > > Moreover it was found that antibiotic treatment, similar to heparin, can stimulate biofilm adherence to the catheter surface [[39](https://pmc.ncbi.nlm.nih.gov/articles/PMC4446496/#B39), [79](https://pmc.ncbi.nlm.nih.gov/articles/PMC4446496/#B79)]. Therefore there is an urgent need for alternative nonantibiotic locks and nonheparin anticoagulants. > … > Nonantibiotic locks or antiseptics kill bacteria through physical effects rather than specific biochemical pathways and may not induce microbial resistance [[80](https://pmc.ncbi.nlm.nih.gov/articles/PMC4446496/#B80)]. Donlan described different approaches to the control of biofilms on intravascular catheters with chelating agents, ethanol, and taurolidine [[73](https://pmc.ncbi.nlm.nih.gov/articles/PMC4446496/#B73)]. Chelating agents have the potential to remove established biofilm (bacteria and fungi). Sodium citrate and ethylenediaminetetraacetic acid (EDTA) are chelating agents. EDTA is used alone or in combinations with antibiotics [[80](https://pmc.ncbi.nlm.nih.gov/articles/PMC4446496/#B80), [81](https://pmc.ncbi.nlm.nih.gov/articles/PMC4446496/#B81)]. > … > > One newly developed locking solution has reduced the ethanol concentration in the locking solution to 20% in combination with 0.01% glyceryl trinitrate and 7% citrate. This lock showed promising results in eradicating biofilm in an _in vitro_ test [[86](https://pmc.ncbi.nlm.nih.gov/articles/PMC4446496/#B86)]. > > Taurolidine, a derivative of the amino acid taurine, is an **antimicrobial agent showing a broad spectrum of antimicrobial activity against both bacteria and fungi** [[87](https://pmc.ncbi.nlm.nih.gov/articles/PMC4446496/#B87), [88](https://pmc.ncbi.nlm.nih.gov/articles/PMC4446496/#B88)]. A meta-analysis of 6 small studies in patients with different catheter types and taurolidine concentrations suggest that taurolidine as locking solution reduces the CRBSI incidence without obvious adverse effects and bacterial resistance [[89](https://pmc.ncbi.nlm.nih.gov/articles/PMC4446496/#B89)]. Abnormal taste sensations were reported in two studies [[90](https://pmc.ncbi.nlm.nih.gov/articles/PMC4446496/#B90), [91](https://pmc.ncbi.nlm.nih.gov/articles/PMC4446496/#B91)]. > > [https://pmc.ncbi.nlm.nih.gov/articles/PMC4446496/](https://pmc.ncbi.nlm.nih.gov/articles/PMC4446496/) > We found that 12.5× diluted solutions of all taurolidine containing formulations completely prevented growth of _Escherichia coli_, _Staphylococcus aureus_ and _Candida glabrata_. Growth of these microbes was detected earlier in 1.34% taurolidine–citrate(–heparin) than in 2% taurolidine, while citrate and heparin did not inhibit growth of clinical isolates compared to PBS. No differences in biofilm formation were found between taurolidine containing solutions. > [https://www.clinicalnutritionjournal.com/article/S0261-5614(14)00131-9/abstract](https://www.clinicalnutritionjournal.com/article/S0261-5614(14)00131-9/abstract) Neat!