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A prospective double blind randomized controlled study on the use of ethanol locks in HPN patients.
Salonen, Bradley R; Bonnes, Sara L; Vallumsetla, Nishanth; Varayil, Jithinraj Edakkanambeth; Mundi, Manpreet S; Hurt, Ryan T.
  • Salonen BR; Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA. Electronic address: salonen.bradley@mayo.edu.
  • Bonnes SL; Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA.
  • Vallumsetla N; Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN, USA.
  • Varayil JE; Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN, USA; Department of Family Medicine, University of Illinois College of Medicine at Rockford, Rockford, IL, USA.
  • Mundi MS; Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN, USA.
  • Hurt RT; Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA; Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN, USA; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA; Division of Gastroenterology, Hepatology and Nutrition
Clin Nutr ; 37(4): 1181-1185, 2018 08.
Article en En | MEDLINE | ID: mdl-28576557
ABSTRACT
BACKGROUND &

AIMS:

Ethanol lock therapy (ELT) has been shown to reduce the rate of catheter-related bloodstream infection (CRBSI) in high-risk home parenteral nutrition (HPN) patients. The aim of this study was to determine whether ELT therapy for all patients newly started on HPN would reduce the incidence of CRBSI.

METHODS:

This study was a prospective, double-blind, randomized controlled trial that was carried out from July 2014 to April 2016. The study participants were patients newly started on HPN, and they were randomly assigned to either treatment with ELT or our current standard of care with saline heparin locks. The primary outcome was occurrence of CRBSI.

RESULTS:

Thirty eight patients that were newly started on HPN were randomized to either treatment with ELT (n = 18) or to our current standard of care with heparin locks (n = 20). Four patients in the ELT group and one patient in the control arm had a CRBSI (p = 0.17). No significant adverse side effects were noted during the study.

CONCLUSIONS:

This study did not show improvement in the rate of CRBSI with ELT in all patients started on HPN. ELT therapy may be most helpful to reduce in CRBSI in high-risk HPN patients, but further studies with a randomized control trial design of high-risk patients are needed to further clarify this important issue in HPN patients. The study was registered at clinicaltrials.gov prior to patient enrollment (NCT02227329).
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Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Cateterismo Venoso Central / Bacteriemia / Nutrición Parenteral en el Domicilio / Etanol / Infecciones Relacionadas con Catéteres Tipo de estudio: Clinical_trials / Observational_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Año: 2018 Tipo del documento: Article

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Cateterismo Venoso Central / Bacteriemia / Nutrición Parenteral en el Domicilio / Etanol / Infecciones Relacionadas con Catéteres Tipo de estudio: Clinical_trials / Observational_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Año: 2018 Tipo del documento: Article