Ethanol-lock technique in the treatment of bloodstream infections in pediatric oncology patients with broviac catheter
Ethanol-lock technique in the treatment of bloodstream infections in pediatric oncology patients with broviac catheter
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DOI：
10.1097/00043426-200308000-00006
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发表时间：
2003-08-01
影响因子：
1.2
通讯作者：
Körholz, D
中科院分区：
文献类型：
--
作者：
Dannenberg, C;Bierbach, U;Körholz, D
目的：评价乙醇锁技术作为治疗中心静脉管路感染的一种方法。血流感染隧道中心静脉导管患者可能会导致删除的lines.Methods：28名儿童和青少年，年龄在2至18岁，不同类型的癌症，有Broviac导管，并提出了积极的血液培养和临床感染的迹象，2000年1月至2001年12月。在18例患者中，除了经验性（最初）和特异性（后10克）静脉抗生素治疗外，还进行了24次乙醇锁技术。在另外15例中，13名儿童接受全身抗生素单独治疗。结果：67%的患者接受乙醇锁治疗4周内或随后的再生障碍性贫血没有任何形式的感染复发，而47%的患者接受全身抗生素单独治疗。在一个男孩中，导管感染不能单独用全身抗生素清除，但在一个疗程的乙醇封管后，没有观察到更多的血培养阳性感染事件。未观察到乙醇冲洗的严重临床副作用。轻微的症状，发生疲劳，头痛，头晕，恶心，和light-headedness.Conclusions：乙醇锁技术似乎是一种安全，耐受性良好，有效的方法来治疗中心静脉管路感染，即使在小的儿童。应设计一项前瞻性随机研究，比较抗生素封管、乙醇封管技术和单独全身抗生素治疗器械相关血流感染的效果。
Purpose: To assess the ethanol-lock technique as a means of treating central venous line infections. Bloodstream infections in patients with tunneled central venous catheters can lead to removal of the lines.Methods: Twenty-eight children and adolescents aged 2 to 18 years, with different types of cancer, had Broviac catheters and presented with positive blood culture and clinical signs of infection between January 2000 and December 2001. The ethanol-lock technique was performed 24 times in 18 patients in addition to empiric (initially) and specific (after antibiogram) intravenous antibiotic treatment. In another 15 cases, 13 children were treated with systemic antibiotics alone.Results: Sixty-seven percent of the patients treated with ethanol locks had no infectious relapse of any kind within 4 weeks of treatment or during subsequent aplasia, compared with 47% treated with systemic antibiotics alone. In one boy the catheter infection could not be cleared with systemic antibiotics alone, but after one course of ethanol locks no more blood culture-positive infectious episodes were observed. No severe clinical side effects of ethanol flush were observed. Mild symptoms that occurred were tiredness, headaches, dizziness, nausea, and light-headedness.Conclusions: The ethanol-lock technique appears to be a safe, well tolerated, and effective way to treat central venous line infections, even in small children. A prospective randomized study should be designed to compare antibiotic-lock, ethanol-lock technique, and systemic antibiotics alone in the treatment of device-associated bloodstream infection.