Abstract
One in ten children with a central venous catheter (CVC) develops a central line-associated bloodstream infection (CLABSI),1 which is a life-threatening complication and harmful distraction from time-sensitive treatment. However, across CVC types (figure), device occlusion is also troublesome and might increase CLABSI risk, presumably through the complementary interactions of fibrin, thrombus, and biofilms.2 The question arises as to what antimicrobial, antithrombotic, or other solution can be periodically instilled (known as locked) within the CVC to prevent one, or preferably both, of these complications. Furthermore, which solutions could effectively treat such complications, should they arise, without needing to remove the CVC? Few high-quality randomised controlled trials have addressed these questions, and it is difficult to find two health-care institutions that share identical policies for lock solution type, concentration, frequency, or duration of dwell. This situation has probably resulted in preventable injuries in children who rely on CVCs to administer treatment.
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