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Clinical Trial
. 2020 Mar;62(3):379-385.
doi: 10.1111/ped.14096.

Ethanol lock therapy in pediatric patients: A multicenter prospective study

Masahiro Chiba  1 , Takeo Yonekura  2 , Tatsuru Kaji  3 , Shintaro Amae  4 , Yuko Tazuke  5 , Mitsugu Oowari  6 , Kazuko Obana  7 , Miwako Nakano  8 , Tasuo Kuroda  9 , Kouzi Fukumoto  10 , Yusuke Yamane  11 , Hiroaki Yoshino  12 , Tatsuzo Hebiguchi  13 , Akira Toki  14
Affiliations
Clinical Trial

Ethanol lock therapy in pediatric patients: A multicenter prospective study

Masahiro Chiba et al. Pediatr Int. 2020 Mar.

Abstract

Background: Ethanol lock therapy (ELT) has been performed for the purpose of preserving central venous catheters (CVC) in central venous catheter-related blood stream infection (CRBSI), but evidence for its effectiveness is not established. We conducted a multicenter, prospective study on the ELT protocol to ascertain its safety and effectiveness against CRBSI.

Methods: The subjects were patients aged over 1 year with potential for developing CRBSI who had long-term indwelling silicone CVCs. After culturing the catheterized blood, a 70% ethanol lock was performed daily for 2-4 h for 7 days. The effectiveness rate of ELT for single and multiple courses, the presence or absence of relapse of CRBSI within 4 weeks of treatment, and whether the CVC could be salvaged after 4 weeks were examined.

Results: From September 2014 to August 2018, 49 cases from six hospitals were enrolled in the study. Catheter blockage was seen in one case and the CVC was removed. A single course of ELT was effective in episodes 88% (42/48). In the remaining three episodes that failed after a single course of ELT, a second ELT was performed; however, all were ineffective. In episodes 93% (40/42), no CRBSI relapse was seen up to 4 weeks after the end of treatment. In episodes 84% (41/49), the catheter could be preserved for 4 weeks or more after the end of treatment. Facial flushing was seen in two cases as an adverse event; however, this was transient and soon disappeared.

Conclusion: ELT is effective for 88% of CRBSI and 84% of catheters can be salvaged; therefore, this protocol is considered useful.

Trial registration: UMIN000013677.

Keywords: catheter-related blood stream infection; central venous catheter; children; ethanol lock therapy; prospective study.

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References

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