Journal article
Pilot trial: 8.4% sodium bicarbonate locks for infection prevention in pediatric intestinal failure
Nutrition in clinical practice
02/25/2026
DOI: 10.1002/ncp.70112
PMID: 41741971
Abstract
Pediatric patients with intestinal failure (IF) require long-term central vascular catheters (CVCs) for parenteral nutrition, placing them at high risk for catheter-related bloodstream infections (CRBSIs). Sodium bicarbonate (NaHCO₃) locks have shown potential in reducing CRBSIs in adult populations, but data in pediatric patients with IF remain limited.
We conducted an open-label prospective cohort study at a tertiary medical center to evaluate the impact of 8.4% NaHCO₃ locks on CRBSI and CVC replacement rates in pediatric patients with IF (ClinicalTrials.gov NCT05927484). The baseline period (heparin locks) was assessed retrospectively, whereas the intervention period (NaHCO₃ locks) was evaluated prospectively. Primary outcome was CRBSI rate; secondary outcomes included CVC replacement because of CRBSI and infection-related hospitalizations.
In the per‑protocol analysis, six patients contributed 5733 total catheter days (3244 on heparin, 2489 on NaHCO₃). CRBSI rates decreased from a median of 8.2 to 3.0 per 1000 catheter days after switching to NaHCO₃ locks (P = 0.11). A similar downward trend was observed in the intent‑to‑treat analysis. A statistically significant reduction in CVC replacement because of CRBSI was observed (2.3 vs 0 per 1000 catheter days; P = 0.03). Trends toward reduced hospital and intensive care unit admissions were also noted in the intervention group. No serious adverse events were attributed to NaHCO₃ lock use.
NaHCO₃ locks appear to be a safe and promising strategy for reducing CRBSI-related complications in pediatric patients with IF, especially where access to more effective lock solutions is limited. Larger prospective studies are needed to confirm these findings.
Details
- Title: Subtitle
- Pilot trial: 8.4% sodium bicarbonate locks for infection prevention in pediatric intestinal failure
- Creators
- Mary Beth Hovda Davis - University of Iowa, NursingAndrew Smelser - Children's Healthcare of AtlantaRiad Rahhal - Peoria campus of the University of Illinois System
- Resource Type
- Journal article
- Publication Details
- Nutrition in clinical practice
- DOI
- 10.1002/ncp.70112
- PMID
- 41741971
- NLM abbreviation
- Nutr Clin Pract
- ISSN
- 1941-2452
- eISSN
- 1941-2452
- Publisher
- Wiley
- Language
- English
- Electronic publication date
- 02/25/2026
- Academic Unit
- Stead Family Department of Pediatrics; Nursing; Gastroenterology, Hepatology, Pancreatology, and Nutrition
- Record Identifier
- 9985141999702771
Metrics
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