Ethanol lock therapy in pediatric patients: A multicenter prospective study. Issue 3 (3rd April 2020)

• Record Type: Journal Article
• Authors: Chiba, Masahiro; Yonekura, Takeo; Kaji, Tatsuru; Amae, Shintaro; Tazuke, Yuko; Oowari, Mitsugu; Obana, Kazuko; Nakano, Miwako; Kuroda, Tasuo; Fukumoto, Kouzi; Yamane, Yusuke; Yoshino, Hiroaki; Hebiguchi, Tatsuzo; Toki, Akira
• Is Part Of: Pediatrics international. Volume 62:Issue 3(2020)
• Page Start: 379
• Page End: 385
• Publication Date: 2020-04-03
• Subjects: catheter‐related blood stream infection -- central venous catheter -- children -- ethanol lock therapy -- prospective study; Pediatrics -- Periodicals; 618.92
• DOI: 10.1111/ped.14096
• Languages: English
• ISSNs: 1328-8067

Abstract

Abstract: Background: Ethanol lock therapy (ELT) has been performed for the purpose of preserving central venous catheters (CVC) in central venous catheter‐related blood stream infection (CRBSI), but evidence for its effectiveness is not established. We conducted a multicenter, prospective study on the ELT protocol to ascertain its safety and effectiveness against CRBSI. Methods: The subjects were patients aged over 1 year with potential for developing CRBSI who had long‐term indwelling silicone CVCs. After culturing the catheterized blood, a 70% ethanol lock was performed daily for 2–4 h for 7 days. The effectiveness rate of ELT for single and multiple courses, the presence or absence of relapse of CRBSI within 4 weeks of treatment, and whether the CVC could be salvaged after 4 weeks were examined. Results: From September 2014 to August 2018, 49 cases from six hospitals were enrolled in the study. Catheter blockage was seen in one case and the CVC was removed. A single course of ELT was effective in episodes 88% (42/48). In the remaining three episodes that failed after a single course of ELT, a second ELT was performed; however, all were ineffective. In episodes 93% (40/42), no CRBSI relapse was seen up to 4 weeks after the end of treatment. In episodes 84% (41/49), the catheter could be preserved for 4 weeks or more after the end of treatment. Facial flushing was seen in two cases as an adverse event; however, this was transient and soon disappeared. Conclusion: ELT is effective for 88% of CRBSI and 84% of catheters can be salvaged; therefore, this protocol is considered useful. Trial registration: UMIN000013677.