title: Central venous catheter thrombosis associated with 70% ethanol locks in pediatric intestinal failure patients on home parenteral nutrition: a case series.
abstract: Central venous catheter (CVC) ethanol locks may reduce catheter-related bloodstream infection (CRBSI). Four children with intestinal failure on home parenteral nutrition (HPN) were selected for 70% ethanol locks because of their high rate of CRBSI. The 70% ethanol locks were instilled at a volume equal to the estimated internal volume of the CVC. Two children (aged 4 and 11 years) received 70% ethanol locks as CRBSI prophylaxis; another 2 children (aged 10 and 11 years) received 70% ethanol locks as adjunctive treatment for CRBSI. All 4 children developed either visible thrombosis in the CVC or CVC occlusion. To the authors' knowledge, this is the first report of CVC thrombosis associated with ethanol lock therapy in the pediatric HPN population. Although none of the CVCs were removed due to occlusion, these events raise serious concerns about the use of high-concentration ethanol locks.
authors: Nutrition Support Service, Department of Gastroenterology and Clinical Nutrition, Royal Children's Hospital, Victoria, Australia. theodoric.wong@rch.org.au
authors: Theodoric
authors: T
authors: Wong
authors: Vanessa
authors: V
authors: Clifford
authors: Zoë
authors: Z
authors: McCallum
authors: Helen
authors: H
authors: Shalley
authors: Megan
authors: M
authors: Peterkin
authors: Georgia
authors: G
authors: Paxton
authors: Julie E
authors: JE
authors: Bines
mesh_terms: D016470:Bacteremia / Q000209:etiology / Q000517:prevention & control; D055499:Catheter-Related Infections / Q000517:prevention & control; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation; D002648:Child; D002675:Child, Preschool; D000431:Ethanol / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000628:therapy*; D008297:Male; D016331:Parenteral Nutrition, Home / Q000009:adverse effects / Q000295:instrumentation*; D056824:Upper Extremity Deep Vein Thrombosis / Q000209:etiology*
chemical_list: D000431:Ethanol