Pediatric Surgery International

, Volume 34, Issue 1, pp 71–74 | Cite as

Hidden morbidity of ethanol lock therapy

  • Teerin T. Meckmongkol
  • Caitlyn Costanzo
  • Sean Ciullo
  • Rajeev Prasad
  • L. Grier Arthur
Original Article
  • 167 Downloads

Abstract

Aims

Long-term central venous catheters are essential in sustaining growth and development in patients with intestinal failure (IF). Several strategies have been developed to prevent and treat catheter-related blood stream infections (CRBSIs), including ethanol lock therapy. We sought to evaluate the efficacy of ethanol lock therapy in our IF population.

Method

This is a retrospective review of IF patients treated with ethanol lock therapy at a single institution from 2006 to 2013. We evaluated the number of catheter days, rate of CRBSI per 1000 catheter days, rate of central venous catheter (CVC) thrombosis, rate of CVC breakage, total number of CVC replacements, total number of hospital admissions, and total number days in the hospital.

Result

We identified 19 patients who underwent ethanol lock therapy for CRBSI. There was no difference in CRBSI rate prior to (5.6 per 1000 catheter days) and after (7 per 1000 catheter days) initiation of ethanol lock therapy. The mean rate of thrombosis increased from 0 to 3 per 1000 catheter days with ethanol lock therapy (p < 0.05). In addition, the CVC breakage rate increased from 0 to 13.7 per 1000 catheter days with ethanol lock therapy (p < 0.001). Hospital admissions and catheter-related ER visits increased following the initiation of ethanol lock therapy.

Conclusions

Contrary to other studies, there was no difference in CRBSI rate prior to and after initiation of ethanol lock therapy. Factors in the methodology of ethanol lock therapy may influence the effectiveness of infection prevention associated with ethanol lock therapy, as well as the rate of line breakage, line thrombosis, and the need for line replacement.

Keywords

Ethanol lock therapy Catheter-related blood stream infections Intestinal failure 

Notes

Compliance with ethical standards

Conflict of interest

The authors have no financial disclosures or conflicts of interest.

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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  1. 1.Division of Pediatric Surgery, Department of SurgerySt. Christopher’s Hospital for ChildrenPhiladelphiaUSA

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