Use of Ethanol Lock for Primary Prevention of Catheter Related Blood Stream Infection in Pediatric Surgical Patients

Abstract

Background: Catheter related blood stream infection (CRBSI) is one of the most serious complications of the central venous catheterization and can lead to severe sepsis, catheter loss, and death. The ethanol lock (EL) is now widely used as a second line therapy and secondary prevention of CRBSI especially in patients with intestinal failure. Objective: The present study’s objective was to evaluate the effectiveness of EL as the primary prevention of CRBSI in pediatric surgical patients. Materials and Methods: The present study was an experimental study that used EL in all pediatric surgical patients with central venous catheter (CVC) hospitalized between February 2020 and January 2021.The EL was done by indwelling the CVC with 70% ethanol for at least four hours per day, then the ethanol was aspirated from the catheter before routine using of the catheter. Data collection included demographics, catheter days, complication of CVC, and EL were collected. Statistical analysis was done using SPSS statistics program. Results: All 13 patients enrolled in the present study had intestinal failure or other gastrointestinal conditions that required a long-term CVC. The results showed no CRBSI in all patients. After using the EL for 1,930 catheter days, the incidence rate of CRBSI was 0 per 1,000 catheter days. The EL group was 1.29 times more likely not to develop CRBSI (RR 1.29, 95% CI 1.10 to 1.52). The authors’ CRBSI rates have declined from 3.84 per 1,000 catheter days in 2019 to 0 per 1,000 catheter days after using EL. One patient had central line removal due to mechanical breakage of the line while returning home. Conclusion: EL prevents CRBSI effectively in pediatric surgical patients especially in tunneled catheter usage. Keywords: Ethanol lock; Catheter related blood stream infection; Central venous catheter