Impact of short term use of interdialytic 60% ethanol lock solution on tunneled silicone catheter dysfunction

Ae, Heng; Mh, Abdelkader; Diaconita, Mirela; Nony, Alain; Guerraoui, A.; Caillot, Nicolas; Rincé, M; Deteix, P; Souweine, Bertrand

doi:10.5414/cn106559

Cited by 18 publications

(12 citation statements)

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“…This may be due to our practice of early introduction of 70% ethanol into the CVCs (as soon as there was a 2‐hour window between administrations of PN) and its daily use. Our findings are in agreement with several adult studies performed in patients with IF who were relying on PN, as well as in patients with chronic kidney failure who were requiring renal replacement therapy, where ELT was associated with higher rates of CVC occlusion and catheter leakage 6 , 22 . ‐ 26 In children undergoing intestinal rehabilitation, mechanical complications such as CVC occlusions and thromboses have been reported with flushing 10 , 22 as well as withdrawal of ethanol from the CVC at the end of the dwell time 1 .…”

Section: Discussionsupporting

confidence: 90%

Effects of Ethanol Lock Therapy on Central Line Infections and Mechanical Problems in Children With Intestinal Failure

Mokha

Davidovics

Samela

et al. 2016

J Parenter Enteral Nutr

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Section: Discussionsupporting

confidence: 90%

Effects of Ethanol Lock Therapy on Central Line Infections and Mechanical Problems in Children With Intestinal Failure

Mokha

Davidovics

Samela

et al. 2016

J Parenter Enteral Nutr

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“…A recent study of 90 episodes of 48 hour 60% ethanol locks in 30 HD patients with evaluation of the pre- and post-intervention period (each patient acting as their own control) found a transient increase in catheter dysfunction related to ethanol lock therapy, although no catheter required removal [20]. Each patient had a total of only three consecutive ethanol dwell periods, such that the effect of ethanol locking in the longer term in this patient population was not able to be assessed.…”

Section: Discussionmentioning

confidence: 99%

A randomised controlled trial of Heparin versus EthAnol Lock THerapY for the prevention of Catheter Associated infecTion in Haemodialysis patients – the HEALTHY-CATH trial

et al. 2012

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BackgroundTunnelled central venous dialysis catheter use is significantly limited by the occurrence of catheter-related infections. This randomised controlled trial assessed the efficacy of a 48 hour 70% ethanol lock vs heparin locks in prolonging the time to the first episode of catheter related blood stream infection (CRBSI).MethodsPatients undergoing haemodialysis (HD) via a tunnelled catheter were randomised 1:1 to once per week ethanol locks (with two heparin locks between other dialysis sessions) vs thrice per week heparin locks.ResultsObserved catheter days in the heparin (n=24) and ethanol (n=25) groups were 1814 and 3614 respectively. CRBSI occurred at a rate of 0.85 vs. 0.28 per 1000 catheter days in the heparin vs ethanol group by intention to treat analysis (incident rate ratio (IRR) for ethanol vs. heparin 0.17; 95%CI 0.02-1.63; p=0.12). Flow issues requiring catheter removal occurred at a rate of 1.6 vs 1.4 per 1000 catheter days in the heparin and ethanol groups respectively (IRR 0.85; 95% CI 0.20-3.5 p =0.82 (for ethanol vs heparin).ConclusionsCatheter survival and catheter-related blood stream infection were not significantly different but there was a trend towards a reduced rate of infection in the ethanol group. This study establishes proof of concept and will inform an adequately powered multicentre trial to definitively examine the efficacy and safety of ethanol locks as an alternative to current therapies used in the prevention of catheter-associated blood stream infections in patients dialysing with tunnelled catheters.Trial RegistrationAustralian New Zealand Clinical Trials Registry ACTRN12609000493246

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“…Occasional information indirectly suggest the effectiveness of ethanol in preventing infections in the subgroups of patients on Total Parenteral Nutrition [15], [34] and in other patients [37] but different adverse events including thrombosis and catheter dysfunction were also reported [15], [35], [38].…”

Section: Discussionmentioning

confidence: 99%

Ethanol Lock Therapy (E-Lock) in the Prevention of Catheter-Related Bloodstream Infections (CR-BSI) after Major Heart Surgery (MHS): A Randomized Clinical Trial

et al. 2014

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BackgroundLock-therapy with antimicrobials has been used for the treatment and prevention of catheter-related bloodstream infections (CR-BSI). Experiences with Ethanol-Locks (E-locks) have included therapeutic interventions with variable results. Patients undergoing Major Heart Surgery (MHS) are a high-risk population for CR-BSI.The aim of this study was to assess the efficacy and tolerance to E-Locks in the prevention of CR-BSI of patients undergoing MHS.Methods and FindingsThis is an academic, prospective, randomized, non-blinded and controlled clinical trial assessing the incidence of CR-BSI of patients with E-locks (E-lock) and the tolerance to the procedure in comparison with patients receiving conventional catheter-care (CCC). Patients undergoing MHS with intravascular catheters for more than 48 hours were randomly assigned into treatment or control group by a computer-generated list of randomly assigned numbers. In the treatment group, all their catheter lumens were locked with an ethanol solution at 70% for two hours, every three days (E-Locks). The control group received conventional catheter-care (CCC).Overall, 200 patients with 323 catheters were included in the study, which was stopped after 10 months due to adverse events. Of them, 179 catheters (113 patients) had E-Locks and 144 catheters (87 patients) were CCC. Euroscore Surgical Risk in both groups was 4.04 vs 4.07 p = 0.94 respectively. The results for the E-Locks and CCC were as follows: Incidence of CR-BSI/1000 days of exposure 2.1 vs 5.2 (p = 0.33), catheter tip colonization 14 (7.8%) vs 6 (4.2%) patients (p = 0.17), median length of hospital stay, 15 vs 16 days (p = 0.77). Seven patients (6.19%), all in the ethanol branch, had to discontinue the trial due to intolerance or adverse events.ConclusionsWe do not recommend prophylaxis of CR-BSI with ethanol-lock on a routine basis in patients undergoing Major Heart Surgery.Trial RegistrationClinical Trials.gov NCT01229592

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Impact of short term use of interdialytic 60% ethanol lock solution on tunneled silicone catheter dysfunction

Cited by 18 publications

References 0 publications

Effects of Ethanol Lock Therapy on Central Line Infections and Mechanical Problems in Children With Intestinal Failure

Effects of Ethanol Lock Therapy on Central Line Infections and Mechanical Problems in Children With Intestinal Failure

A randomised controlled trial of Heparin versus EthAnol Lock THerapY for the prevention of Catheter Associated infecTion in Haemodialysis patients – the HEALTHY-CATH trial

Ethanol Lock Therapy (E-Lock) in the Prevention of Catheter-Related Bloodstream Infections (CR-BSI) after Major Heart Surgery (MHS): A Randomized Clinical Trial

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