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Ethanol locks for the prevention of catheter-related infection in patients with central venous catheter: A systematic review and meta-analysis of randomized controlled trials


Autoři: Jun Zhang aff001;  Bo Wang aff001;  Jinxia Wang aff001;  Qin Yang aff002
Působiště autorů: School of Nursing, Gansu University of Chinese Medicine, Lanzhou, Gansu, China aff001;  Department of Special Surgery, the First Hospital of Lanzhou University, Lanzhou, Gansu, China aff002
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0222408

Souhrn

Background

The widespread use of central venous catheters (CVCs) has exposed patients to a high risk of catheter-related infection (CRI), which is linked to substantial morbidity and mortality. Several strategies for preventing CRI, including ethanol lock prophylaxis, have been explored. This study aimed to provide a comprehensive summary of randomized controlled trials (RCTs) assessing the efficacy and safety of ethanol locks for preventing CRI in patients with CVC.

Methods

We searched six electronic databases, earlier relevant meta-analyses and the reference lists of the included studies for RCTs that assessed the effects of ethanol locks on CRI in patients with CVC versus a control group. Two authors independently assessed the methodological quality of the included studies using the Cochrane Risk of Bias tool and extracted relevant information according to a predesigned extraction form. Data were analyzed using the Cochrane Collaboration’s RevMan 5.3.

Results

Nine studies involving 2451 patients were included. Although limited in power, the results of the meta-analysis indicated a positive effect of ethanol lock prophylaxis on reducing catheter-related bloodstream infection (CRBSI) compared to heparin alone [OR = 0.53, 95% CI 0.34, 0.82, P = 0.004]. The effects on other outcomes, such as exit site infection, catheter dysfunction, catheter removal, thrombosis and mortality, were not statistically significant (P > 0.05). Moreover, although the effect of ethanol on CRBSI was in the expected direction compared to 0.9% NaCl locks, this effect was not statistically significant (P > 0.05).

Conclusions

The present data indicate that ethanol lock prophylaxis is a potential candidate for the prevention of CRBSI in patients with CVC. However, more attention should be paid to the uniform ethanol lock procedure and toxic effects after long-term ethanol lock exposure.

Klíčová slova:

Biology and life sciences – Bioengineering – Biotechnology – Physical sciences – Chemistry – Engineering and technology – Research and analysis methods – Mathematics – Medicine and health sciences – Chemical compounds – Organic compounds – Organic chemistry – Pharmacology – Statistics – Mathematical and statistical techniques – Statistical methods – Metaanalysis – Research design – Hematology – Drugs – Clinical research design – Adverse events – Research assessment – Systematic reviews – Vascular medicine – Medical devices and equipment – Cardiovascular medicine – Nephrology – Medical dialysis – Alcohols – Catheters – Cardiovascular diseases – Ethanol – Heparin – Blood coagulation – Coagulation disorders – Thrombosis


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