 |
|
Ethanol-Lock Technique for Persistent Bacteremia of Long-term Intravascular Devices in Pediatric Patients
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instilled with a dose volume of 0.8 to 1.4 mL of 70% ethanol into the catheter lumen during 12 to 24 hours and then withdrawn.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  Delicious  Digg  Facebook  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Ethanol Locks to Prevent Catheter-Related Bloodstream Infections in Parenteral Nutrition: A Meta-Analysis
Oliveira et al.
Pediatrics 2012;129:318-329.
ABSTRACT
| FULL TEXT
New Advances in the Management of Children With Intestinal Failure
Peterson and Kerner
JPEN J Parenter Enteral Nutr 2012;36:36S-42S.
FULL TEXT
Short-Dwell Ethanol Lock Therapy in Children Is Associated With Increased Clearance of Central Line-Associated Bloodstream Infections
McGrath et al.
CLIN PEDIATR 2011;50:943-951.
ABSTRACT
Ethanol-Lock Therapy for the Prevention of Central Venous Access Device Infections in Pediatric Patients With Intestinal Failure
Cober et al.
JPEN J Parenter Enteral Nutr 2011;35:67-73.
ABSTRACT
| FULL TEXT
Parenteral Fish Oil Monotherapy in the Management of Patients With Parenteral Nutrition-Associated Liver Disease
de Meijer et al.
Arch Surg 2010;145:547-551.
ABSTRACT
| FULL TEXT
Diagnosis, prevention and treatment of haemodialysis catheter-related bloodstream infections (CRBSI): a position statement of European Renal Best Practice (ERBP)
Vanholder et al.
Clin Kidney J 2010;3:234-246.
FULL TEXT
Clinical Practice Guidelines for the Diagnosis and Management of Intravascular Catheter-Related Infection: 2009 Update by the Infectious Diseases Society of America
Mermel et al.
Clinical Infectious Diseases 2009;49:1-45.
ABSTRACT
| FULL TEXT
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
|
