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Archives of Pediatrics and Adolescent Medicine
Article . 2006 . Peer-reviewed
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Ethanol-Lock Technique for Persistent Bacteremia of Long-term Intravascular Devices in Pediatric Patients

Authors: Cathy E. Shin; Stana Fustar; Wes Onland; Wing-Yen Wong; Teresa Rushing;

Ethanol-Lock Technique for Persistent Bacteremia of Long-term Intravascular Devices in Pediatric Patients

Abstract

To use the ethanol-lock technique (in conjunction with systemic antibiotics) to salvage central lines from removal and to prevent persistence of catheter-related infections among pediatric patients with long-term intravascular devices.Medical records of patients treated with ethanol locks were retrospectively reviewed from June 1, 2004, through June 22, 2005.Childrens Hospital Los Angeles, Los Angeles, Calif, a tertiary care pediatric hospital. Patients Forty children with diverse underlying disorders were treated for 51 catheter-related infections using the Childrens Hospital Los Angeles ethanol-lock technique.Eligible infected central lines were instilled with a dose volume of 0.8 to 1.4 mL of 70% ethanol into the catheter lumen during 12 to 24 hours and then withdrawn. The volume of ethanol used was based on the type of intravascular device.Clearance of infection and incidence of recurrence.Of the 51 ethanol-lock treatments in 40 children, no catheters were removed because of persistent infection. Eighty-eight percent (45/51) of the treated episodes cleared without recurrence (defined as a relapse within 30 days with the same pathogen). Twelve (75%) of 16 polymicrobial isolates and 33 (94%) of 35 monomicrobial isolates were successfully treated. There were no adverse reactions or adverse effects reported.This retrospective study supports the use of the ethanol-lock technique in conjunction with systemic antibiotics as an effective and safe method to retain the use of a previously infected central venous catheter, decrease the need for line removal, and eradicate persistent pathogens in catheter-related infections.

Keywords

Male, Catheterization, Central Venous, Adolescent, Ethanol, Infant, Bacteremia, Equipment Design, Catheters, Indwelling, Child, Preschool, Anti-Infective Agents, Local, Humans, Female, Child, Retrospective Studies

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    118
    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 10%
    influence
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    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 10%
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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
118
Top 10%
Top 10%
Top 10%
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