Ethanol Lock Therapy Markedly Reduces Catheter-Related Blood Stream Infections in Adults Requiring Home Parenteral Nutrition: A Retrospective Study From a Tertiary Medical Center.
Ethanol Lock Therapy Markedly Reduces Catheter-Related Blood Stream Infections in Adults Requiring Home Parenteral Nutrition: A Retrospective Study From a Tertiary Medical Center.
复制标题
乙醇封管疗法可显着减少需要家庭肠外营养的成人的导管相关血流感染：来自三级医疗中心的回顾性研究。
DOI：
10.1002/jpen.1698
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Ziegler,ThomasR
中科院分区：
文献类型：
--
作者：
Gundogan,Kursat;Dave,NishaJ;Griffith,DanielP;Zhao,VivianM;McNally,ThereseA;Easley,KirkA;Haack,CarlaI;Galloway,JohnR;Ziegler,ThomasR
背景：使用中心静脉导管（CVC）进行家庭肠外营养（HPN）与导管相关性血流感染（crbsi）相关。在成人HPN患者中使用乙醇锁定疗法（ELT）预防CRBSI的数据有限。我们的目的是确定与美国乔治亚州亚特兰大市埃默里大学医院（EUH）的历史对照组相比，常规ELT制度是否降低了CRBSI的发生率。方法回顾性研究在预先确定的14个月观察期（n = 87； 13386导尿管日）中，在内镜下行隧道式硅胶CVC的成年HPN患者的医疗记录，并将所有合适的患者与同一机构在内镜下插管前临床相似的HPN患者进行比较。ELT方案包括在HPN周期后，在初始生理盐水冲洗后，每天向每个导管腔内灌注2ml 70%乙醇。结果87例接受ELT的患者中，仅有5例（5.7%）在观察期间被诊断为CRBSI（0.45/1000导管天）。我们将这些数据与之前发表的临床匹配的EUH患者群体（n = 22）进行了比较，这些患者通过硅胶CVC接受了不带ELT的HPN。在这些历史对照中，45.5%在观察期间被诊断为1次或更多crbsi（8.7/1000导管天）（与当前的ELT队列相比P< 0.001）。结论：在同一学术中心的回顾性对照研究中，通过硅胶CVC进行HPN的成人ELT制度与CRBSI的显着（19倍）降低相关。
BackgroundThe use of central venous catheter (CVC) access for home parenteral nutrition (HPN) is associated with catheter‐related bloodstream infections (CRBSIs). There are limited data on the use of ethanol lock therapy (ELT) to prevent CRBSI in adult HPN patients. Our aim was to determine whether the routine institution of ELT decreased the incidence of CRBSI compared with historic controls at Emory University Hospital (EUH) in Atlanta, Georgia, USA.MethodsEUH medical records of adult HPN patients discharged with a tunneled, silicone CVC on ELT were retrospectively studied during a pre‐hoc determined 14‐month observation period (n = 87; 13,386 catheter days) and compared with clinically similar HPN patients from the same institution before institution of the ELT protocol for all appropriate patients. The ELT protocol involved instilling 2 mL of 70% ethanol into each catheter lumen daily after the HPN cycle, following initial flushing with normal saline.ResultsOnly 5 of 87 patients (5.7%) who received ELT were diagnosed with a CRBSI (0.45/1000 catheter days) during observation. We compared these data with our previously published clinically matched patient population from EUH (n = 22) receiving HPN via a silicone CVC without ELT. Of these historical controls, 45.5% were diagnosed with 1 or more CRBSIs (8.7/1000 catheter days) during observation (P< .001 vs the current ELT cohort).ConclusionsIn this retrospective study with historical controls from the same academic center, institution of ELT in adults requiring HPN via a silicone CVC was associated with a marked (19‐fold) reduction in CRBSI.
影响因子：
7.4
作者：
R. Sternberg;P. Coulet;J. Laurent
通讯作者：
J. Laurent