Preliminary results of a phase i trial of prophylactic ethanol-lock administration to prevent mediport catheter-related bloodstream infections Journal Article
| Authors: | Kayton, M. L.; Garmey, E. G.; Ishill, N. M.; Cheung, N. K. V.; Kushner, B. H.; Kramer, K.; Modak, S.; Rossetto, C.; Hennelly, C.; Parra Doyle, M.; Rosenberg, S.; Santoro, O.; La Quaglia, M. P. |
| Article Title: | Preliminary results of a phase i trial of prophylactic ethanol-lock administration to prevent mediport catheter-related bloodstream infections |
| 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/questionnaires to assess symptoms and measured blood ethanol levels and liver functions. Patients were tracked for positive blood cultures. Time to infection for ethanol-lock-treated patients was compared with historical controls. Results: We administered 123 ethanol-locks. No adverse symptoms attributable to ethanol occurred; one patient's urticaria worsened. Blood ethanol levels averaged 11 mg/dL. The study was voluntarily suspended after 3 patients' catheters became occluded, 1 of which fractured. A positive blood culture occurred in 1 (8%) of 12 patients, but suspension of the study precluded statistical power to detect impact on time to infection. Conclusions: Although children with mediport catheters exhibited nontoxic blood ethanol levels and a low rate of bloodstream infections following prophylactic ethanol-lock use, there was a high incidence of catheter occlusion. Adjustments are necessary before adopting ethanol-locks for routine prophylaxis against catheter infections in children. © 2010 Elsevier Inc. All rights reserved. |
| Keywords: | clinical article; treatment outcome; clinical trial; liver function; prospective studies; antibodies, monoclonal; immunoglobulin g; neuroblastoma; alcohol; heparin; thorax radiography; bacteremia; drug blood level; phase 1 clinical trial; infection prevention; catheter infection; catheter-related infections; antibody; cross infection; catheters, indwelling; urticaria; ethanol; antihistaminic agent; central venous catheter; blood culture; catheter-related bloodstream infection; ethanol-lock; mediport; nosocomial infection; catheter occlusion; structured questionnaire; anti-infective agents; catheterization, central venous; equipment contamination |
| Journal Title: | Journal of Pediatric Surgery |
| Volume: | 45 |
| Issue: | 10 |
| ISSN: | 0022-3468 |
| Publisher: | W.B. Saunders Co-Elsevier Inc. |
| Date Published: | 2010-10-01 |
| Start Page: | 1961 |
| End Page: | 1966 |
| Language: | English |
| DOI: | 10.1016/j.jpedsurg.2010.05.014 |
| PUBMED: | 20920713 |
| PROVIDER: | scopus |
| PMCID: | PMC4572738 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 20 April 2011" - "CODEN: JPDSA" - "Source: Scopus" |
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
Related MSK Work