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Therapeutic and prophylactic ethanol lock therapy in patients with bleeding disorders
Author(s) -
Rajpurkar M.,
McGrath E.,
Joyce J.,
BoldtMacDonald K.,
Chitlur M.,
Lusher J.
Publication year - 2014
Publication title -
haemophilia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.213
H-Index - 92
eISSN - 1365-2516
pISSN - 1351-8216
DOI - 10.1111/hae.12241
Subject(s) - medicine , venous access , catheter , complication , surgery , antimicrobial , clotting factor , central venous catheter , chemistry , organic chemistry
Summary Obtaining a reliable venous access is a limiting factor for early initiation of clotting factor prophylaxis and immune tolerance induction. To circumvent this issue, central venous access devices ( CVAD s) are increasingly being used. Catheter‐related infections ( CRI s) remain the primary complication of insertion of CVAD . Thus, newer strategies for treatment and prevention of CRI are needed. Ethanol lock therapy ( ELT ) has been used to treat and prevent CRI in non‐bleeding disorder patients. The aim of this study was to assess the efficacy of ELT in treating and preventing CRI in bleeding disorder patients. The medical charts of patients with bleeding disorders who underwent ELT for antimicrobial resistant CRI s were reviewed and data were analysed. ELT was effective in catheter salvage in 87% of patients with antimicrobial resistant CRI by a wide variety of pathogens. Prophylactic therapy with ethanol lock was associated with catheter dysfunction especially in mediports. ELT should be considered prior to removal of catheters in bleeding disorder patients with resistant CRI s. Further studies are needed for using prophylactic ethanol lock in prevention of CRI s in bleeding disorder patients.