“We aim to describe our experience with prophylactic ethanol locks in a cohort of patients with IF” Mezoff et al (2015).
Mezoff, E.A., Fei, L., Troutt, M., Klotz, K., Kocoshis, S.A. and Cole, C.R. (2015) Ethanol Lock Efficacy and Associated Complications in Children With Intestinal Failure. Journal of Parenteral & Enteral Nutrition. February 23rd. .
Background: Prophylactic ethanol lock therapy (ELT) reduces central line–associated bloodstream infections (CLA-BSIs) in children with intestinal failure (IF). However, the risk of associated complications is unclear. We aim to describe our experience with prophylactic ethanol locks in a cohort of patients with IF.
Materials and Methods: Thirty patients on ELT from 2010–2013 were identified by review of our intestinal rehabilitation registry. Patient demographics, CLA-BSI events, and line complications were extracted. Comparisons in infection and complication rates when on and off ELT were made using a Poisson mixed-effect regression model.
Results: CLA-BSIs when on and off ELT were 3.1 and 5.5 per 1000 catheter days, respectively (P < .015). Overall complication rates were similar in both groups. In those patients who experienced a complication, the complication rates on ELT compared with time off ELT were significantly lower (P < .003). Line perforation or breakage rates declined significantly when on ELT, from 1.8 to 1.53 per 1000 catheter days (P < .006). Line occlusion rates also decreased on ELT, from 0.6 to 0.3 per 1000 catheter days (P = .056). Infecting organisms were not different on and off ELT, and patients experienced a similar number of polymicrobial infections on or off therapy. Klebsiella pneumoniae was the most common infecting organism in both groups.
Conclusions: Ethanol lock therapy use reduces both CLA-BSI and central line complication rates in children with IF. These results underscore the safety and efficacy of ELT use in this population.
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