Onland Wes, Shin Cathy E, Fustar Stana, Rushing Teresa, Wong Wing-Yen
Department of Pediatrics, Emma Children's Hospital, Academic Medical Center, Amsterdam, the Netherlands.
Arch Pediatr Adolesc Med. 2006 Oct;160(10):1049-53. doi: 10.1001/archpedi.160.10.1049.
To use the ethanol-lock technique (in conjunction with systemic antibiotics) to salvage central lines from removal and to prevent persistence of catheter-related infections among pediatric patients with long-term intravascular devices.
Medical records of patients treated with ethanol locks were retrospectively reviewed from June 1, 2004, through June 22, 2005.
Childrens Hospital Los Angeles, Los Angeles, Calif, a tertiary care pediatric hospital. Patients Forty children with diverse underlying disorders were treated for 51 catheter-related infections using the Childrens Hospital Los Angeles ethanol-lock technique.
Eligible infected central lines were instilled with a dose volume of 0.8 to 1.4 mL of 70% ethanol into the catheter lumen during 12 to 24 hours and then withdrawn. The volume of ethanol used was based on the type of intravascular device.
Clearance of infection and incidence of recurrence.
Of the 51 ethanol-lock treatments in 40 children, no catheters were removed because of persistent infection. Eighty-eight percent (45/51) of the treated episodes cleared without recurrence (defined as a relapse within 30 days with the same pathogen). Twelve (75%) of 16 polymicrobial isolates and 33 (94%) of 35 monomicrobial isolates were successfully treated. There were no adverse reactions or adverse effects reported.
This retrospective study supports the use of the ethanol-lock technique in conjunction with systemic antibiotics as an effective and safe method to retain the use of a previously infected central venous catheter, decrease the need for line removal, and eradicate persistent pathogens in catheter-related infections.
采用乙醇封管技术（联合全身使用抗生素）以避免拔除中心静脉导管，并预防长期使用血管内装置的儿科患者发生导管相关感染。
对2004年6月1日至2005年6月22日期间接受乙醇封管治疗的患者病历进行回顾性分析。
加利福尼亚州洛杉矶市的洛杉矶儿童医院，一家三级儿科护理医院。患者40名患有各种基础疾病的儿童使用洛杉矶儿童医院的乙醇封管技术治疗了51例导管相关感染。
对于符合条件的感染中心静脉导管，在12至24小时内将0.8至1.4 mL的70%乙醇注入导管腔，然后抽出。所用乙醇的量基于血管内装置的类型。
感染清除情况及复发率。
在40名儿童接受的51次乙醇封管治疗中，没有因持续感染而拔除导管的情况。88%（45/51）的治疗发作感染清除且无复发（定义为在30天内由同一病原体导致的复发）。16株多微生物分离株中的12株（75%）和35株单微生物分离株中的33株（94%）得到成功治疗。未报告有不良反应或不良事件。
这项回顾性研究支持乙醇封管技术联合全身使用抗生素作为一种有效且安全的方法，可保留先前感染的中心静脉导管的使用，减少拔管需求，并根除导管相关感染中的持续病原体。
