Journal
ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE
Volume 160, Issue 10, Pages 1049-1053Publisher
AMER MEDICAL ASSOC
DOI: 10.1001/archpedi.160.10.1049
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Objectives: 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 longterm intravascular devices. Design: Medical records of patients treated with ethanol locks were retrospectively reviewed from June 1, 2004, through June 22, 2005. Setting: 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. Interventions: 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instilled with a dose volume of 0.8 to 1.4 mL of 70% ethanol into the catheter lumen during 12 to 24 hours and then withdrawn.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. Main Outcome Measures: Clearance of infection and incidence of recurrence. Results: 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. Conclusion: 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.
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