Background Patients with intestinal failure (IF) are dependent on parenteral nutrition (PN), however, they are at risk of central line–associated bloodstream infections (CLABSIs) and line complications. Four‐percent tetrasodium ethylenediaminetetraacetic acid (EDTA) solution is an effective nonantibiotic, antimicrobial, antibiofilm, and anticoagulant agent. Our objective was to determine 4% tetrasodium EDTA efficacy in preventing CLABSIs and reducing line occlusions in pediatric IF patients. Methods We conducted a retrospective cohort study of patients managed at 2 tertiary Canadian pediatric centers between April 2016 and December 2018 who received 4% tetrasodium EDTA solution under the brand name Kitelock. Data were collected for 12 months pre and post‐Kitelock. CLABSIs and alteplase administration were compared using a Wilcoxon matched‐pairs signed‐rank test. Data were reported as medians and frequencies. Results Twenty patients were included (10 boys; median age, 83 months [range, 8–232 months]). The rate of CLABSIs before 4% tetrasodium EDTA was 2.7+4 per 1000 catheter days. Patients received 4% tetrasodium EDTA for a median of 365 (278–365) days, with no infections in the 12 months post‐therapy (P = .002). Median rates of occlusive episodes for the entire cohort before 4% tetrasodium EDTA were 0 (0–5.0) and 0 (0–2.0) after starting therapy (P = .018). In patients with previous occlusions (n = 9), the median episodes of alteplase use previously was 5.5 (2.7–19.2) compared with 2.7 (0–2.7) (P = .018). Conclusions Our preliminary findings suggest 4% tetrasodium EDTA solution is effective in reducing CLABSIs and catheter occlusions in pediatric patients with long‐term central‐access.

Background Published reports on abnormal body composition in pediatric patients with intestinal failure have been in patients with poor growth. The goal of the current study is to report the body composition of normally growing patients with intestinal failure. Methods Children 8–18 years old with a dual‐energy x‐ray absorptiometry (DXA) between January 1, 2013, and July 15, 2018, were included in the study. Data were retrospectively collected from the medical charts and included demographics, residual bowel anatomy, nutrition support, height, and weight. DXA data, including total body less head bone mineral density (BMD), fat mass (FM), and fat‐free mass (FFM), were collected and compared with published literature controls matched for age and sex. Results Thirty‐four children met inclusion criteria. Mean age at the time of DXA was 9.6 ± 1.8 years. Weight‐ and height‐for‐age z‐scores were −0.4 ± 0.9 and −0.5 ± 1.0, respectively. Mean BMD z‐score was −1.0 ± 1.3. Twenty‐six percent of patients (n = 9) had reduced BMD. Patients with intestinal failure had higher FM (P = .02) and lower FFM (P = .02) compared with controls. Conclusions These data show that, despite reference range z‐scores for height and weight, children with intestinal failure are at risk for abnormal body composition. Body composition should be routinely measured in children with intestinal failure to direct nutrition interventions.

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