論文

査読有り 国際誌
2020年3月

Ethanol lock therapy in pediatric patients: A multicenter prospective study.

Pediatrics international : official journal of the Japan Pediatric Society
  • Masahiro Chiba
  • ,
  • Takeo Yonekura
  • ,
  • Tatsuru Kaji
  • ,
  • Shintaro Amae
  • ,
  • Yuko Tazuke
  • ,
  • Mitsugu Oowari
  • ,
  • Kazuko Obana
  • ,
  • Miwako Nakano
  • ,
  • Tasuo Kuroda
  • ,
  • Kouzi Fukumoto
  • ,
  • Yusuke Yamane
  • ,
  • Hiroaki Yoshino
  • ,
  • Tatsuzo Hebiguchi
  • ,
  • Akira Toki

62
3
開始ページ
379
終了ページ
385
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1111/ped.14096

BACKGROUND: Ethanol lock therapy (ELT) has been performed for the purpose of preserving central venous catheters (CVC) in central venous catheter-related blood stream infection (CRBSI), but evidence for its effectiveness is not established. We conducted a multicenter, prospective study on the ELT protocol to ascertain its safety and effectiveness against CRBSI. METHODS: The subjects were patients aged over 1 year with potential for developing CRBSI who had long-term indwelling silicone CVCs. After culturing the catheterized blood, a 70% ethanol lock was performed daily for 2-4 h for 7 days. The effectiveness rate of ELT for single and multiple courses, the presence or absence of relapse of CRBSI within 4 weeks of treatment, and whether the CVC could be salvaged after 4 weeks were examined. RESULTS: From September 2014 to August 2018, 49 cases from six hospitals were enrolled in the study. Catheter blockage was seen in one case and the CVC was removed. A single course of ELT was effective in episodes 88% (42/48). In the remaining three episodes that failed after a single course of ELT, a second ELT was performed; however, all were ineffective. In episodes 93% (40/42), no CRBSI relapse was seen up to 4 weeks after the end of treatment. In episodes 84% (41/49), the catheter could be preserved for 4 weeks or more after the end of treatment. Facial flushing was seen in two cases as an adverse event; however, this was transient and soon disappeared. CONCLUSION: ELT is effective for 88% of CRBSI and 84% of catheters can be salvaged; therefore, this protocol is considered useful. TRIAL REGISTRATION: UMIN000013677.

リンク情報
DOI
https://doi.org/10.1111/ped.14096
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/31840325

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