title: Ethanol Lock Efficacy and Associated Complications in Children With Intestinal Failure.
abstract: Prophylactic ethanol lock therapy (ELT) reduces central line-associated bloodstream infections (CLA-BSIs) in children with intestinal failure (IF). However, the risk of associated complications is unclear. We aim to describe our experience with prophylactic ethanol locks in a cohort of patients with IF.
  
  
  
  Thirty patients on ELT from 2010-2013 were identified by review of our intestinal rehabilitation registry. Patient demographics, CLA-BSI events, and line complications were extracted. Comparisons in infection and complication rates when on and off ELT were made using a Poisson mixed-effect regression model.
  
  
  
  CLA-BSIs when on and off ELT were 3.1 and 5.5 per 1000 catheter days, respectively (P <015). Overall complication rates were similar in both groups. In those patients who experienced a complication, the complication rates on ELT compared with time off ELT were significantly lower (P <003). Line perforation or breakage rates declined significantly when on ELT, from 1.8 to 1.53 per 1000 catheter days (P <006). Line occlusion rates also decreased on ELT, from 0.6 to 0.3 per 1000 catheter days (P =056). Infecting organisms were not different on and off ELT, and patients experienced a similar number of polymicrobial infections on or off therapy. Klebsiella pneumoniae was the most common infecting organism in both groups.
  
  
  
  Ethanol lock therapy use reduces both CLA-BSI and central line complication rates in children with IF. These results underscore the safety and efficacy of ELT use in this population.
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition ethan.mezoff@cchmc.org.
authors.forename: Ethan A
authors.initials: EA
authors.lastname: Mezoff
authors.affiliation: Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
authors.forename: Lin
authors.initials: L
authors.lastname: Fei
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition.
authors.forename: Misty
authors.initials: M
authors.lastname: Troutt
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition.
authors.forename: Kim
authors.initials: K
authors.lastname: Klotz
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition.
authors.forename: Samuel A
authors.initials: SA
authors.lastname: Kocoshis
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition.
authors.forename: Conrad R
authors.initials: CR
authors.lastname: Cole
mesh_terms: D000293:Adolescent; D016470:Bacteremia / Q000382:microbiology / Q000517:prevention & control*; D055499:Catheter-Related Infections / Q000382:microbiology / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D062905:Central Venous Catheters / Q000009:adverse effects / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D000431:Ethanol; D005260:Female; D006801:Humans; D007223:Infant; D007410:Intestinal Diseases / Q000628:therapy*; D007710:Klebsiella Infections / Q000517:prevention & control; D007711:Klebsiella pneumoniae; D008297:Male; D055815:Young Adult
chemical_list: D000431:Ethanol
keywords: central line–associated bloodstream infection; central venous catheter; ethanol lock; intestinal failure