Seventy percent of infants with IF achieved EA. Residual small and large bowel length were the most important predictors of EA and septic events had a negative impact.
Background
Patients with intestinal failure (IF) are dependent on parenteral nutrition (PN), however, they are at risk of central line–associated bloodstream infections (CLABSIs) and line complications. Four‐percent tetrasodium ethylenediaminetetraacetic acid (EDTA) solution is an effective nonantibiotic, antimicrobial, antibiofilm, and anticoagulant agent. Our objective was to determine 4% tetrasodium EDTA efficacy in preventing CLABSIs and reducing line occlusions in pediatric IF patients.
Methods
We conducted a retrospective cohort study of patients managed at 2 tertiary Canadian pediatric centers between April 2016 and December 2018 who received 4% tetrasodium EDTA solution under the brand name Kitelock. Data were collected for 12 months pre and post‐Kitelock. CLABSIs and alteplase administration were compared using a Wilcoxon matched‐pairs signed‐rank test. Data were reported as medians and frequencies.
Results
Twenty patients were included (10 boys; median age, 83 months [range, 8–232 months]). The rate of CLABSIs before 4% tetrasodium EDTA was 2.7+4 per 1000 catheter days. Patients received 4% tetrasodium EDTA for a median of 365 (278–365) days, with no infections in the 12 months post‐therapy (P = .002). Median rates of occlusive episodes for the entire cohort before 4% tetrasodium EDTA were 0 (0–5.0) and 0 (0–2.0) after starting therapy (P = .018). In patients with previous occlusions (n = 9), the median episodes of alteplase use previously was 5.5 (2.7–19.2) compared with 2.7 (0–2.7) (P = .018).
Conclusions
Our preliminary findings suggest 4% tetrasodium EDTA solution is effective in reducing CLABSIs and catheter occlusions in pediatric patients with long‐term central‐access.
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