Sodium Bicarbonate Locks May Be a Safe and Effective Alternative in Pediatric Intestinal Failure: A Pilot Study

Area of Science:

• Pediatric Gastroenterology
• Infectious Diseases
• Vascular Access Management

Background:

• Pediatric intestinal failure (IF) often requires central venous catheters (CVCs).
• Ethanol lock therapy (ELT) is used to prevent complications, but alternatives are sought.
• Catheter-related blood stream infections (CRBSIs) are a significant concern in IF patients.

Purpose of the Study:

• To compare the efficacy and safety of sodium bicarbonate lock therapy (SBLT) versus ELT in pediatric IF patients.
• To evaluate the rates of CRBSI, hospitalizations, emergency room (ER) visits, and CVC-related complications.
• To assess the safety profile of SBLT in this vulnerable population.

Main Methods:

• Retrospective study comparing outcomes in pediatric IF patients.
• Patients were switched from ELT to SBLT.
• Primary outcome: CRBSI rate. Secondary outcomes: hospitalization, ER visits, and CVC-related complications.

Main Results:

• Median CRBSI rates were 2.77 per 1000 catheter days on ELT versus 0 on SBLT (P=0.17).
• Median hospitalization and ER visit rates for CVC complications were 6.1 and 2.8 on ELT versus 0 and 1.8 on SBLT, respectively.
• Rates of CVC-related complications were similar between therapies; no adverse events were reported with SBLT.

Conclusions:

• Sodium bicarbonate lock therapy (SBLT) may be a safe and effective alternative to ELT for preventing complications in pediatric IF patients.
• The study suggests a potential reduction in CRBSIs and CVC-related complications with SBLT.
• Further prospective studies are recommended to validate these findings.