Sodium bicarbonate IV locks
This was a retrospective study that compared outcomes in pediatric intestinal failure (IF) patients that were switched from ethanol lock therapy (ELT) to sodium bicarbonate lock therapy (SBLT). The primary outcome was rate of catheter-related blood stream infections (CRBSI). The secondary outcomes were number of hospitalizations, ER visits, central venous catheter (CVC) -related complications. In four patients, median rates of CRBSI were 2.77 (IQR 0.6-5.6) on ELT versus 0 on SBLT per 1000 catheter days (p=0.17). The median rates of hospitalizations and emergency room (ER) visits for CVC-related complications were 6.1 (IQR 3.2-10.2) on ELT versus 0 on SBLT (IQR 0-0) (p=0.11) and 2.8 (IQR 2-3.6) on ELT versus 1.8 (IQR 0-3.7) on SBLT per 1000 catheter days (p=0.50), respectively. Rates of CVC-related complications were similar. No adverse events were reported. SBLT may be safe and effective for pediatric IF.
Josyabhatla R, Naik M, Liu Y, Speer AL, Imseis EM. Sodium bicarbonate locks may be a safe and effective alternative in pediatric intestinal failure – a pilot study. J Pediatr Gastroenterol Nutr. 2022 Jun 7. doi: 10.1097/MPG.0000000000003506. Epub ahead of print. PMID: 35675704.