This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (15)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Bacterial Infections  • Infectious Diseases, Other  • Infectious Diseases  • Alert me on articles by topic  Social Bookmarking   What's this?

Wes Onland, MD; Cathy E. Shin, MD; Stana Fustar, RN, CRNI; Teresa Rushing, PharmD, BCPS; Wing-Yen Wong, MD

Arch Pediatr Adolesc Med. 2006;160:1049-1053.

Objectives  To use the ethanol-lock technique (in conjunction with systemic antibiotics) to salvage central lines from removal and to prevent persistence of catheter-related infections among pediatric patients with long-term intravascular devices.

Design  Medical records of patients treated with ethanol locks were retrospectively reviewed from June 1, 2004, through June 22, 2005.

Setting  Childrens Hospital Los Angeles, Los Angeles, Calif, a tertiary care pediatric hospital.

Patients  Forty children with diverse underlying disorders were treated for 51 catheter-related infections using the Childrens Hospital Los Angeles ethanol-lock technique.

Interventions  Eligible infected central lines were instilled with a dose volume of 0.8 to 1.4 mL of 70% ethanol into the catheter lumen during 12 to 24 hours and then withdrawn. The volume of ethanol used was based on the type of intravascular device.

Main Outcome Measures  Clearance of infection and incidence of recurrence.

Results  Of the 51 ethanol-lock treatments in 40 children, no catheters were removed because of persistent infection. Eighty-eight percent (45/51) of the treated episodes cleared without recurrence (defined as a relapse within 30 days with the same pathogen). Twelve (75%) of 16 polymicrobial isolates and 33 (94%) of 35 monomicrobial isolates were successfully treated. There were no adverse reactions or adverse effects reported.

Conclusion  This retrospective study supports the use of the ethanol-lock technique in conjunction with systemic antibiotics as an effective and safe method to retain the use of a previously infected central venous catheter, decrease the need for line removal, and eradicate persistent pathogens in catheter-related infections.

Author Affiliations: Department of Pediatrics, Emma Children's Hospital, Academic Medical Center, Amsterdam, the Netherlands (Dr Onland); and Divisions of Pediatric Surgery (Dr Shin), Hematology-Oncology (Ms Fustar and Drs Rushing and Wong), and Pharmacy (Dr Rushing), Childrens Hospital Los Angeles, Los Angeles, Calif.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Asaia lannaensis bloodstream infection in a child with cancer and bone marrow transplantation
Abdel-Haq et al.
J Med Microbiol 2009;58:974-976.
FULL TEXT  

Comparison of various antimicrobial agents as catheter lock solutions: preference for ethanol in eradication of coagulase-negative staphylococcal biofilms
Qu et al.
J Med Microbiol 2009;58:442-450.
ABSTRACT | FULL TEXT  

Effectiveness of a 30% ethanol/4% trisodium citrate locking solution in preventing biofilm formation by organisms causing haemodialysis catheter-related infections
Takla et al.
J Antimicrob Chemother 2008;62:1024-1026.
ABSTRACT | FULL TEXT  

A prospective double-blind randomized trial comparing intraluminal ethanol with heparinized saline for the prevention of catheter-associated bloodstream infection in immunosuppressed haematology patients
Sanders et al.
J Antimicrob Chemother 2008;62:809-815.
ABSTRACT | FULL TEXT  

Reduced Biocide Susceptibility in Candida albicans Biofilms
Nett et al.
Antimicrob. Agents Chemother. 2008;52:3411-3413.
ABSTRACT | FULL TEXT