Experience of the use of lock therapy in pediatric patients with central venous catheter
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Published on: July 13, 2019
Laura Fernanda Niño-Serna1, Catalina Mesa Muftoz1, Diana Copete1
1Hospital Pablo Tobón Uribe, Medellín, Colombia.
Insights
Lock therapy effectively preserves catheters in pediatric patients, achieving 75% success with therapeutic use and 62% with prophylactic use. This method is particularly beneficial for cancer patients with neutropenia.
Area of Science:
- Pediatric critical care
- Infectious disease management
- Oncology support
Background:
- Indwelling catheters are crucial for managing pediatric patients, but catheter patency and infection prevention remain significant challenges.
- Lock therapy is a recognized method for preserving catheter function, yet data from Latin America is limited.
- Understanding the efficacy and characteristics of lock therapy in a Colombian pediatric population is essential for clinical practice.
Purpose of the Study:
- To characterize pediatric patients undergoing therapeutic or prophylactic lock therapy over a six-year period.
- To evaluate the catheter preservation rates and identify factors influencing success in a high-complexity Colombian hospital.
- To describe the clinical profiles, interventions, and outcomes associated with lock therapy in this cohort.
Main Methods:
- A cross-sectional descriptive study was conducted on pediatric patients (<18 years) receiving lock therapy.
- Data collected included demographics, clinical diagnoses, laboratory results (including neutropenia), interventions, and mortality.
- Descriptive statistical analysis was employed to summarize the findings.
Main Results:
- The study included 54 pediatric patients with 67 episodes of therapeutic lock therapy; hematological neoplasms were the most common diagnosis (61%).
- Catheter preservation was achieved in 75% of therapeutic uses and 62% of prophylactic uses (ethanol 70%).
- Neutropenia was present in 88% of patients receiving therapeutic lock therapy, with higher preservation rates (80%) in cancer patients.
Conclusions:
- Lock therapy demonstrates significant efficacy in preserving indwelling catheters in pediatric patients, with varying success rates for therapeutic and prophylactic applications.
- The study highlights the utility of lock therapy in managing neutropenic pediatric cancer patients.
- Aminoglycosides and vancomycin were the primary antibiotics used, and mortality from catheter-related bacteremia was low (6%).
Abstract:
Lock therapy is useful for preserving indwelling catheters. Few lock therapy studies have been published in Latin America.
Objective:
To describe the clinical characteristics of pediatric patients using therapeutic and prophylactic lock therapy for six years in a high-complexity hospital in Colombia.
Patients And Method:
Cross-sectional descriptive study of patients aged < 18 years who received lock therapy. Collected variables included demographic data, clinical characteristics, blood test results, therapeutic interventions, frequency of admission to the pediatric critical care unit, and mortality. Descriptive analysis was performed.
Results:
54 patients were included in the study, most of them males, with 67 episodes of therapeutic lock therapy use. The most frequent diagnosis was hematological neoplasm (61%). Among these patients, 88% presented neutropenia while receiving lock therapy. Catheter preservation was achieved in 75% of the cases. Aminoglycosides were the most commonly used antibiotics (38%). Mortality due to catheter-related bacteremia was 6%. Catheter preservation using ethanol solution 70% was achieved in 62% of the patients with prophylactic lock therapy, all of whom had chronic gastrointestinal pathology.
Conclusion:
Catheter preservation rates were 75% and 62% in patients with therapeutic and prophylactic lock therapy, respectively, with a higher rate achieved among cancer patients with neutropenia (80%). Aminoglycosides and vancomycin were the most commonly used antibiotics.
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