MO788: Ethanol Lock Solution for Prophylaxis of CRBSI of Non-Tunnelled Catheters in Haemodialysis Patients

Abstract

BACKGROUND AND AIMS Prevention of catheter related blood stream infection (CRBSI) is a major challenge in hemodialysis (HD) patients. Efficacy of 70% ethanol as a catheter lock solution for the treatment of tunnelled cuff catheter's (TCC's) CRBSI is widely studied [1, 2]. Prophylactic use of ethanol lock was limited to small number of studies especially involving paediatric and home parenteral nutrition (HPN) patients [3] and studies in chronic HD patients with TCCs [4, 5]. But its role in prophylaxis of CRBSI for non-tunnelled catheter (NTC's) is less explored. METHOD We conducted a single centre prospective study from May 2019 to May 2020. A total of 62 patients of end-stage renal disease (ESRD) requiring NTC's for the initiation of HD in emergency or maintenance of HD while waiting for the creation or maturation of an already created arteriovenous fistula (AVF) or for TCC insertion were included. The study population was divided into two groups, Group A (n = 31) received 70% ethanol with heparin 2000 IU as a catheter lock solution. Group B (n = 31) received standard heparin 2000 IU as a catheter lock. RESULTS The primary endpoint of the study was the rate of CRBSI, in group A 6.5% (n = 2) it was significantly lower compared with group B 25.8% (n = 8), (P = 0.038) and when the CRBSI rate/1000 days was calculated, for group A it was 2.2/1000 catheter days and for group B it was 9.6/1000 catheter days (P = 0.04). The mean duration of catheter survival was not significantly different for group A (29.97 ± 6.7) days and group B (26.42 ± 8.04) days. CONCLUSION 70% ethanol lock along with heparin may be safe and effective as a catheter lock for prophylaxis of CRBSI.