Canterbury DHB
Tunnelled catheters are an essential part of treatment of patients undergoing chemotherapy for haematological disease or Bone Marrow Transplant.
Catheter-related sepsis is an important complication of tunnelled central venous catheters.
Up to 40% of neutropenic patients experience at least one episode of bacteraemia, much of which is attributed to catheter-related sepsis and represent a major hazard to the patient.
Ethanol is effective against a wide range of micro-organisms, including Staphylococcus aureus, Coagulase negative staphylococci, Streptococci, Escherichia coli, Pseudomonas aeruginosa and Candida albicans.
Two hours of contact is required to kill organisms in the biofilm. Ethanol locks of up to 4 hours may be necessary for biofilms that have been present for more than 1–2 days. For prophylaxis (in-patients only) an ethanol lock, 2 mL of 70% ethanol, is inserted into each lumen and left for at least 2 hours on Tuesdays and Fridays. If there is a line infection the same amount of ethanol is placed down each lumen daily for as long as the patient is receiving IV antibiotics. It is left in the line for 2-4 hours.
Ethanol locks can only be used with silicon catheters.
Topic Code: 5039