Information copied from: The Journal of the Association for Vascular Access
Volume 19, #4. Winter 2014.
Stephanie Pitts, MSN, RN, CPN, VA-BC
Dale Bergamo, MD
Carlos Cartaya, MD
St Joseph’s Children’t Hospital, Tampa, FL
Beth Gore, PhD
Efficacy in the Reduction of Central Line Associated Bloodstream Infection in a Patient With Intestinal Failure: An Ethanol Lock Pediatric Case Study
Background:
When a patient experiences intestinal failure, IF, they are given a CVC to apply the nutrients that their body isn’t able to absorb itself. This puts them at risk for central line-associated bloodstream infections, CLABSI, at the site of administration.
The U.S. alone has an estimated 250,000-500,000 cases of bloodstream infections annually. Each episode costs roughly $55,000. To understand how to minimize and eliminate risk of infection attention has been directed to the outcomes of patients receiving prophylactic antimicrobial lock solutions. The Centers for Disease Control and Prevention state “Use prophylactic antimicrobial lock solution in patients with long term catheters and a history of multiple catheter related blood stream infections despite maximal adherence to aseptic technique.”
Ethanol lock therapy is an antimicrobial solution that shows promising outcomes for patients with IF.
Case Study:
In a specific case study following pediatric patient with a history of health issues and complications with catheters, the implementation of ethanol lock therapy allowed the patient to maintain 0 CLABSI for a duration of over 33 months.
The patient received 20% (.3mL) medical grade ethanol through a Brociac catheter three times a week. The ethanol dwells in the catheter while the patient is off parenteral nutrition.
Outcomes:
After 25 months the patient had 7 catheter disruptions that needed repair but had zero CLABSIs. A month later a new Broviac was placed, due to instability of the pervious one, and ethanol lock therapy was restarted with an end result of over 33 months with zero CLABSIs at the completion of the study.
Further studies are still needed to maximize the potential of ethanol lock therapy and prevention of CLABSI but it is clear that the administration of ethanol lock therapy was instrumental in maintaining the life line for the patient of the case study.
For more information visit the Association for Vascular Access.
