Official Sections CTRMS ISVCA IPITA IPTA ISODP IRTA IXA SPLIT TID

2013 - ISBTS 2013 Symposium


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Mini-Oral Communications 1

12.240 - Ethanol locks decrease catheter related bloodstream infection (CRBSI) admissions in home parenteral nutrition (HPN) patients

Presenter: Koji, Hashimoto, , United States
Authors: Ezra Steiger1, Denise Konrad1, Rocio Lopez1, Rex Speerhas1, Abdullah Shatnawei1, Karen Giaco1, Donald Kirby1

Ethanol locks decrease catheter related bloodstream infection (CRBSI) admissions in home parenteral nutrition (HPN) patients

Ezra Steiger1, Denise Konrad1, Rocio Lopez1, Rex Speerhas1, Abdullah Shatnawei1, Karen Giaco1, Donald Kirby1

1Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, United States

Introduction
Catheter related bloodstream infections (CRBSI) necessitate hospital readmissions and is a potential indication, if recurrent or severe, for small intestinal transplantation. We present our experience using ethanol locks to prevent tunneled cuffed catheter infections in HPN patients
 
Materials and Methods
A prospective clinical management database is maintained by the Nutrition Support Team for the management of patients on HPN at the Cleveland Clinic.  Readmissions and reasons for readmission to the hospital are entered into the system and maintained for quality assurance purposes as well as patient management. We have recently began using an ethanol lock system initially for those patients with recurrent CRBSI’s and most recently in 2012 for all patients discharged on HPN with a tunneled cuffed catheter. The database was queried regarding the use of ethanol locks and CRBSI’s from Jauary 2010 through February of 2013. A Poisson regression model was used to assess changes in CRBSI admission rates through the years.
 
Results
 
 

 

Use of EtOH lock and CRBSI rates in HPN patients
 
2010
2011
2012
2013
Total patients active with HPN
330
342
442
272
Number of new patients discharged on HPN
193
197
273
40
Number of patients discharged with EtOH lock
71
58
190
26
Total CRBSI admissions
104
74
60
6
Total catheter days
47256
57245
74439
14802
% of new HPN pts dicharged with EtOH lock
36.8
29.4
69.6
65
CRBSI admissions per 1000 catheter days
(95% CI)
2.20
(1.78, 2.62)
1.29
(1.00, 1.59)
0.81
(0.60, 1.01)
0.41
(0.08, 0.73)
 
 
 
 
 
Conclusion

The use of ethanol locks has been associated with a significant decrease in CRBSI’s (p<0.001) in our HPN patients


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