Use of ethanol lock therapy to reduce the incidence of catheter-related bloodstream infections in home parenteral nutrition patients

Marianne T Opilla; Donald F Kirby; Michael B Edmond

doi:10.1177/0148607107031004302

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Use of ethanol lock therapy to reduce the incidence of catheter-related bloodstream infections in home parenteral nutrition patients

Journal article

Peer reviewed

Use of ethanol lock therapy to reduce the incidence of catheter-related bloodstream infections in home parenteral nutrition patients

Marianne T Opilla, Donald F Kirby and Michael B Edmond

JPEN. Journal of parenteral and enteral nutrition, Vol.31(4), pp.302-305

07/2007

DOI: 10.1177/0148607107031004302

PMID: 17595439

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Abstract

Catheter-related bloodstream infection (CRBSI) is a serious complication for home parenteral nutrition (HPN) patients. To reduce the incidence of infection in frequently infected HPN patients, prophylactic ethanol lock therapy (ELT) was initiated. Nine patients were selected as candidates for ELT because of their history of recurrent CRBSI. Diagnosis of CRBSI was determined by symptoms correlating with positive peripheral and access device blood cultures. Medical-grade ethyl alcohol 25%-70% was instilled into the central venous access device and allowed to dwell for 2-4 hours. The incidence of CRBSI and catheter changes was compared before and after initiation of ELT. Nine patients experienced 81 CRBSIs (8.3 per 1,000 catheter-days) before starting ELT vs 9 infections (2.7 per 1,000 catheter-days: relative risk [RR], 0.325; confidence interval [CI] 95%, 0.17-0.64) after ELT. Catheter changes were also reduced from 69 (7.0 per 1000 days) before ELT to 1 (0.3 per 1,000 days: RR, 0.043; CI 95%, 0.01-0.25) after ELT. No significant adverse effects were noted, although some patients complained of transient dizziness and nausea. ELT shows promise in reducing the incidence of CRBSI in the frequently infected HPN population. Further studies are warranted.

Dose-Response Relationship, Drug

Ethanol - pharmacology

Bacteremia - prevention & control

Cross Infection - prevention & control

Ethanol - adverse effects

Humans

Catheters, Indwelling - adverse effects

Bacteremia - epidemiology

Treatment Outcome

Parenteral Nutrition, Home - adverse effects

Catheterization, Central Venous - adverse effects

Cross Infection - epidemiology

Details

Title: Subtitle: Use of ethanol lock therapy to reduce the incidence of catheter-related bloodstream infections in home parenteral nutrition patients
Creators: Marianne T Opilla - Department of Nursing, Nutrishare, Inc., Elk Grove, California, USA. mopilla@nutrishare.com
Donald F Kirby
Michael B Edmond
Resource Type: Journal article
Publication Details: JPEN. Journal of parenteral and enteral nutrition, Vol.31(4), pp.302-305
DOI: 10.1177/0148607107031004302
PMID: 17595439
NLM abbreviation: JPEN J Parenter Enteral Nutr
ISSN: 0148-6071
eISSN: 1941-2444
Publisher: United States
Language: English
Date published: 07/2007
Academic Unit: Infectious Diseases; Internal Medicine
Record Identifier: 9983905647502771

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