Related Experiment Video
Updated: Nov 27, 2025
Long-Term Catheterization of the Intestinal Lymph Trunk and Collection of Lymph in Neonatal Pigs
Published on: March 5, 2016
Prolonged Use of Ethanol Lock Prophylaxis With Polyurethane Catheters in Children With Intestinal Failure: A
Kathryn LaRusso1, Marie-Pier Dumas2, Geraldine Schaack3
1Division of Pediatric General and Thoracic Surgery, Montreal Children's Hospital, McGill University Health Centre, Montreal, Québec, Canada.
Insights
Ethanol lock prophylaxis (ELP) use in children with intestinal failure (IF) receiving home parenteral nutrition (HPN) showed polyurethane catheters had fewer breakages than silicone. Further research is needed to confirm these findings for central venous catheters (CVCs).
Area of Science:
- Pediatric Gastroenterology
- Infectious Disease Prevention
- Medical Device Technology
Background:
- Children with intestinal failure (IF) require long-term central venous catheters (CVCs) for home parenteral nutrition (HPN).
- Ethanol lock prophylaxis (ELP) is used to prevent central line-associated bloodstream infections.
- Concerns exist regarding polyurethane catheter breakage with ELP use.
Purpose of the Study:
- To compare the safety and efficacy of ELP in polyurethane versus silicone CVCs in children with IF receiving HPN.
- To evaluate catheter breakage rates and other complications associated with ELP in different CVC materials.
Main Methods:
- A 10-year retrospective study of pediatric patients with IF receiving HPN and ELP.
- Extraction of complications per 1000 catheter days.
- Multivariable, mixed-effects Poisson modeling to compare polyurethane and silicone CVCs.
Main Results:
- Silicone catheters exhibited a significantly higher breakage rate (RR, 2.86) compared to polyurethane catheters.
- Polyurethane catheters showed higher rates of occlusion and displacements.
- No significant differences were observed in overall catheter replacement rates or other outcomes.
Conclusions:
- ELP use in polyurethane catheters is associated with a lower risk of breakage compared to silicone CVCs in pediatric IF patients on HPN.
- These findings are preliminary and require larger studies for stronger evidence.
- Polyurethane catheters may be a safer option when using ELP in this patient population.
Background:
Children with intestinal failure (IF) receiving home parenteral nutrition (HPN) require long-term central venous catheters (CVCs). Ethanol lock prophylaxis (ELP) can reduce central line-associated bloodstream infections, but there are some concerns of increased breakage rates when used with polyurethane catheters. We reviewed our experience using ethanol locks in both polyurethane and silicone CVCs.
Methods:
A 10-year retrospective study of children with IF receiving HPN that used ELP was conducted. Complications per 1000 catheter days were extracted and a multivariable, mixed-effects Poisson model was used to compare catheter breakage rates and other complications between polyurethane and silicone CVCs.
Results:
A total of 10 patients were included, comprising 85 CVCs and 13,227 catheter days. The most common cause of IF was necrotizing enterocolitis. Breakages were the most common complication: polyurethane 1.46/1000 vs silicone 3.76/1000 catheter days. Silicone catheters had a significantly higher breakage rate (adjusted rate ratio [RR], 2.86; 95% confidence interval [CI], 2.84-2.88; P < .001) whereas polyurethane catheters had higher rates of occlusion (adjusted RR, 0.14; 95% CI, 0.07-0.28; P < .001) and displacements. However, there were no differences in the overall catheter replacement rates and any other catheter-related outcomes.
Conclusions:
In children with IF receiving long-term HPN, the use of ELP in polyurethane catheters was associated with a lower risk of breakages when compared with silicone CVCs. These results should be regarded as preliminary data, and further studies with a higher number of participants are necessary to provide a better level of evidence.
Related Concept Videos
01:25Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications
01:27Parentral Nutrition: Centeral and Peripheral Parental Nutrition
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...