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Ethanol lock therapy: a pilot infusion study in infants.
Rebecca F Chhim1, Catherine M Crill2, Hailey K Collier3
1Department of Clinical Pharmacy, The University of Tennessee Health Science Center, Memphis, TN, USA Le Bonheur Children's Hospital, Memphis, TN, USA rchhim@uthsc.edu.
The Annals of Pharmacotherapy
|January 30, 2015
Summary
Ethanol lock therapy (ELT) flush is safe for infants, showing acceptable blood alcohol levels and no liver injury. Further research is needed for long-term safety and efficacy in preventing central line-associated bloodstream infections (CLABSIs).
Area of Science:
- Neonatal medicine
- Pediatric infectious diseases
- Pharmacology
Background:
- Ethanol lock therapy (ELT) is effective for central line-associated bloodstream infections (CLABSIs).
- Safety of ELT in infants remains undetermined.
- Infants often require central venous catheters (CVCs).
Purpose of the Study:
- To assess blood alcohol concentration (BAC) in infants post-ELT.
- To evaluate for hepatic injury after a small ethanol dose in infants.
- To establish safety parameters for ELT in neonates.
Main Methods:
- Prospective pilot study in infants (≤6 kg) with CVCs.
- Measured 5-minute and 1-hour BACs after a 0.4-mL 70% ethanol flush.
- Assessed hepatic panel components for signs of injury.
Main Results:
- All 10 infants had acceptable BACs (<0.025% at 5 min, <0.01% at 1 hr).
- No infants showed evidence of hepatic injury.
- Most 5-minute BACs were undetectable; all 1-hour BACs were undetectable.
Conclusions:
- A single flush of ELT is safe in infants.
- No immediate hepatic injury or concerning BACs were observed.
- Long-term safety and efficacy of ELT for CLABSI prevention in infants require further investigation.
