Evaluation of Ethanol Lock Therapy in Pediatric Patients on Long‐Term Parenteral Nutrition

Abstract

Our group of patients showed a 73% reduction in CABSIs and a 77% reduction in catheter removal due to infection after ethanol lock therapy. In our patient population, weekly ethanol lock therapy for 2 hours is an effective technique to reduce CABSIs and catheter removal in long-term home PN patients.

Central Catheter–Associated Bloodstream Infection Reduction With Ethanol Lock Prophylaxis in Pediatric Intestinal Failure

“…Our cohort of 24 patients did not change during the course of the intervention but had an increase in overall catheter retention and decrease in new central catheter insertion, which was similar to results from other studies. 14,15,18 18 One patient in our cohort had an adverse event, specifically, a CVC-related occlusion leading to CVC replacement, which was thought to be secondary to ethanol. However, we were unable to prove that this event was directly caused by the ELP, which the patient had been receiving for 310 days.…”

“…In addition, these same data suggest possible but significant complications with ethanol lock use, including catheter thrombosis, which has precluded its more widespread use ( Table 1). [13][14][15][16][17][18] In an attempt to reduce CCABSI infections in our patients and improve clinical outcomes, we performed a qualityimprovement (QI) initiative intended to evaluate whether the addition of ELP to our CCABSI prevention bundle in both the hospital and home settings could safely reduce CCABSI rates in our pediatric patients with IF.…”

Use of Ethanol Lock Therapy for Children with Intestinal Failure on Long-Term Parenteral Nutrition

“…Each child received 70 % ethanol lock for only 2 h once per week, with heparin being used on the remaining days. The baseline rate of CRBSI in these patients was 9.8 per 1,000 catheter days, and this was decreased by 73 % to 2.7 per 1,000 catheter days despite the short and infrequent use of ethanol (Pieroni et al 2013a). Interestingly, there has been a recent shortage of the availability of 70 % ethanol for medical use in the United States, allowing for one group to investigate the rate of CBRSI during the shortage period.…”

Efficacy in the Reduction of Central Line-Associated Bloodstream Infection in a Patient With Intestinal Failure: An Ethanol Lock Pediatric Case Study

“…[1][2][3] With each infection is a 12%-35% attributable mortality and an estimated cost of $55,000 per episode. [3][4][5] Patients who are dependent on parenteral nutrition are at high risk for developing CLABSI. 1,4,6 The catheter provides a prime pathway for exposure to infection.…”

“…[3][4][5] Patients who are dependent on parenteral nutrition are at high risk for developing CLABSI. 1,4,6 The catheter provides a prime pathway for exposure to infection. As a result of the vulnerability, prudent care and maintenance of CVCs must be provided; however, despite the best care of CVCs, infections still occur.…”