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Evaluation of ethanol lock therapy in pediatric patients on long-term parenteral nutrition

Kevin P Pieroni1, Colleen Nespor, Marisa Ng

  • 1Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, Stanford University School of Medicine, Stanford, California, USA.

Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition
|December 13, 2012
PubMed

Insights

Weekly ethanol lock therapy significantly reduced catheter-associated bloodstream infections (CABSIs) and line removals in pediatric home parenteral nutrition (PN) patients. This intervention proved effective in preserving venous access for long-term PN therapy.

Area of Science:

  • Pediatric critical care
  • Infectious disease management
  • Vascular access device care

Background:

  • Pediatric home parenteral nutrition (PN) patients face high risks of catheter-associated bloodstream infections (CABSIs).
  • Recurrent CABSIs can necessitate central venous catheter (CVC) removal, jeopardizing future venous access.
  • Effective strategies are needed to mitigate infection risks in this vulnerable population.

Purpose of the Study:

  • To evaluate the efficacy of weekly ethanol lock therapy in reducing CABSIs.
  • To assess the impact of ethanol lock therapy on CVC removal rates due to infection.
  • To demonstrate a reduction in CABSIs and catheter removals in long-term home PN patients.

Main Methods:

  • A cohort of pediatric PN patients with a history of recurrent CABSIs received weekly ethanol lock therapy.
  • A 70% ethanol solution was instilled into the CVC for 2 hours weekly.
  • CABSIs and infection-related catheter removals were tracked before and after therapy initiation.

Main Results:

  • Ethanol lock therapy reduced CABSIs from 9.8 to 2.7 per 1000 catheter days (P < .001).
  • Catheter removals due to infection decreased from 4.3 to 1.0 per 1000 catheter days.
  • A statistically significant reduction in both infection and removal rates was observed.

Conclusions:

  • Weekly ethanol lock therapy demonstrated a 73% reduction in CABSIs.
  • Catheter removal due to infection was reduced by 77% in the study population.
  • Ethanol lock therapy is an effective method for preventing CABSIs and preserving venous access in long-term pediatric home PN patients.
Abstract

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