2010
DOI: 10.1016/j.jpedsurg.2010.05.014
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Abstract: Background Catheter-related bloodstream infections remain costly with no simple prevention. We report preliminary results of a phase I trial of ethanol-lock administration to prevent mediport catheter-related bloodstream infections in children. Methods Twelve patients receiving intravenous antibody treatments for neuroblastoma were enrolled. On 4 days of each 5-day antibody cycle, 70% ethanol was administered instead of heparin to dwell in each patient’s mediport overnight. We used clinical monitoring/questi… Show more

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Cited by 40 publications
(54 citation statements)
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“…A pesar de ello, es cierto que la posibilidad de que el sellado con etanol incremente el riesgo de oclusión del catéter existe y debería analizarse de forma prospectiva y sistemática en futuros ensayos clínicos. Por último, el uso de etanol se ha asociado también a la aparición de otros efectos adversos sistémicos, como alteraciones en la función hepática, relacionadas, en forma, sobre todo, de elevación de transaminasas (31,44,45). Recientemente Mermel ha publicado una revisión en la que se recogen todos los posibles efectos adversos asociados al uso de etanol que se han comunicado en los últimos 10 años (46).…”
Section: Etanolunclassified
“…A pesar de ello, es cierto que la posibilidad de que el sellado con etanol incremente el riesgo de oclusión del catéter existe y debería analizarse de forma prospectiva y sistemática en futuros ensayos clínicos. Por último, el uso de etanol se ha asociado también a la aparición de otros efectos adversos sistémicos, como alteraciones en la función hepática, relacionadas, en forma, sobre todo, de elevación de transaminasas (31,44,45). Recientemente Mermel ha publicado una revisión en la que se recogen todos los posibles efectos adversos asociados al uso de etanol que se han comunicado en los últimos 10 años (46).…”
Section: Etanolunclassified
“…Thus far, reported symptoms after flushing ethanol include nausea, dizziness, or experiencing an odd taste (Broom et al 2008;Opilla et al 2007;Sanders et al 2008;Slobbe et al 2010). However, there have also been studies using ethanol locks where the patients report no associated symptoms (Jones et al 2010;Kayton et al 2010;Mouw et al 2008). In addition, there is pediatric clinical experience with the use of 95-98 % ethanol for sclerotherapy during the treatment of vascular malformations.…”
Section: Safety Of Ethanol Locksmentioning
confidence: 99%
“…The highest rates of thrombosis were seen in the studies where ethanol was used daily. Kayton et al had 3 out of 12 patients develop catheter thrombosis while using daily ethanol locks for 12 h at a time (Kayton et al 2010), and Mouw et al reported 1 out of 10 children developing catheter thrombosis when using ethanol locks daily for 4-14 h (Mouw et al 2008). A recently published case series noted that clot developed in the CVCs of 4 patients managed with ethanol lock anywhere from 3 to over 400 days after starting the lock therapy (Wong et al 2012).…”
Section: Safety Of Ethanol Locksmentioning
confidence: 99%
“…Four studies were found evaluating ethanol lock therapy for the prevention of CVC infections, including 1 adult RCT [32], 2 pediatric retrospective studies [33,34], and 1 pediatric prospective single-armed study [35] (Table 5). Because most catheters in these studies were salvaged, identifying CVC that strictly satisfied the CRBSI definition was difficult.…”
Section: Are Antibiotic or Ethanol Lock Therapies Effective In Decreamentioning
confidence: 99%
“…The adult RCT as well as the 2 retrospective pediatric studies showed benefit of ethanol lock therapy [32][33][34]. The prospective pediatric study by Kayton et al [35] was the only one that used this therapy on patients with Mediports, and it terminated early because of a high incidence of catheter thrombosis. It is important to note some concerns with ethanol lock therapy: (1) ethanol is not compatible with heparin and will precipitate if exposed to heparinized saline [36], (2) ethanol may weaken silicone CVC and is not recommended for use in polyurethane CVC because of risk of catheter disruption [37], and (3) systemic instillation of ethanol can theoretically result in ethanol intoxication, although none of the aforementioned studies reported this effect.…”
Section: Are Antibiotic or Ethanol Lock Therapies Effective In Decreamentioning
confidence: 99%