Mechanical Complications in Central Lines Using Taurolidine Versus Ethanol Lock Therapy in Children With Intestinal Failure.
J Pediatr Gastroenterol Nutr
; 74(6): 776-781, 2022 06 01.
Article
em En
| MEDLINE
| ID: mdl-35213858
ABSTRACT
OBJECTIVES:
Ethanol lock therapy (ELT) is effective in reducing rates of catheter-related-bloodstream infections (CRBSI) in the pediatric intestinal failure (IF) population; however, ELT may increase the risk of line occlusion and breakage, significantly impacting preservation of vascular access. During a period of ethanol shortage, Health Canada temporarily approved the use of taurolidine lock therapy (TLT) in pediatric iF patients previously utilizing ELT. This provided a unique opportunity to directly compare rates of central venous catheter (CVC) complications, including CRBSi, breaks, occlusions, repairs and replacements in patients who utilized both ELT and TLT.METHODS:
A retrospective study of pediatric IF patients managed by three Western Canadian intestinal rehabilitation programs was performed. Event rates in patients who used both ELT and TLT during the study period were compared using Poisson regression analysis.RESULTS:
In 13 patients with 10,187 catheter days (CDs), TLT (vs ELT) had lower rates of CVC breaks (1.11 vs 5.19/1000 CDs, Pâ<â0.001), occlusions (0.83 vs 4.06/1000 CDs, Pâ =â0.01) and repairs (1.94 vs 5.64/1000 CDs, Pâ =â0.01). There was no difference in CRBSI rates (0.83 vs 2.03/1000 CDs, Pâ =â0.25) or rates of CVC replacements due to mechanical events (0.28 vs 1.81/1000 CDs, Pâ =â0.08).CONCLUSIONS:
Although there was no difference in CRBSI rates, TLT was associated with lower rates of mechanical complications compared to ELT in this study. Taurolidine may be a suitable alternative to ethanol in preventing CRBSI and may be associated with improved preservation of central lines in children with IF.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Cateterismo Venoso Central
/
Bacteriemia
/
Infecções Relacionadas a Cateter
/
Cateteres Venosos Centrais
/
Insuficiência Intestinal
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Child
/
Humans
País/Região como assunto:
America do norte
Idioma:
En
Revista:
J Pediatr Gastroenterol Nutr
Ano de publicação:
2022
Tipo de documento:
Article