Abstract：
BACKGROUND: Central line-associated bloodstream infections are a major concern for children with intestinal failure and in animal research using parenteral nutrition (PN). In neonatal piglets receiving PN, we compared sepsis, line occlusions, line replacements, mortality, and costs with and without the use of a 4%-tetrasodium ethylenediaminetetraacetic acid (T-EDTA) locking solution.
METHODS: We performed a retrospective review of piglets with a central venous jugular catheter enrolled in 14-day exclusive PN (TPN) trials or in 7-day short bowel syndrome (SBS) trials, before and after initiation of T-EDTA. Lines were locked with a 1-ml solution for 2 h daily (T-EDTATPN, n = 17; T-EDTASBS, n = 48) and compared with our prior standard of care using 1.5-ml heparin flushes twice daily (CONTPN, n = 34; CONSBS, n = 48). Line patency and signs of sepsis were checked twice daily. Jugular catheters were replaced for occlusions whenever possible. Humane end points were used for sepsis not responding to antibiotic treatment or unresolved catheter occlusions.
RESULTS: Compared with CON, sepsis was reduced using T-EDTA, significantly for TPN (P = 0.006) and with a trend for SBS piglets (P = 0.059). Line occlusions necessitating line changes were reduced 15% in TPN studies (P = 0.16), and no line occlusions occurred for T-EDTA SBS piglets.
CONCLUSIONS: In our neonatal piglet research, use of T-EDTA locking solution decreased sepsis and, although not statistically significant, reduced occlusions requiring line replacements. Given the expense of animal research, adding a locking solution must be cost-effective, and we were able to show that T-EDTA significantly reduced total research costs and improved animal welfare.
METHODS: We performed a retrospective review of piglets with a central venous jugular catheter enrolled in 14-day exclusive PN (TPN) trials or in 7-day short bowel syndrome (SBS) trials, before and after initiation of T-EDTA. Lines were locked with a 1-ml solution for 2 h daily (T-EDTATPN, n = 17; T-EDTASBS, n = 48) and compared with our prior standard of care using 1.5-ml heparin flushes twice daily (CONTPN, n = 34; CONSBS, n = 48). Line patency and signs of sepsis were checked twice daily. Jugular catheters were replaced for occlusions whenever possible. Humane end points were used for sepsis not responding to antibiotic treatment or unresolved catheter occlusions.
RESULTS: Compared with CON, sepsis was reduced using T-EDTA, significantly for TPN (P = 0.006) and with a trend for SBS piglets (P = 0.059). Line occlusions necessitating line changes were reduced 15% in TPN studies (P = 0.16), and no line occlusions occurred for T-EDTA SBS piglets.
CONCLUSIONS: In our neonatal piglet research, use of T-EDTA locking solution decreased sepsis and, although not statistically significant, reduced occlusions requiring line replacements. Given the expense of animal research, adding a locking solution must be cost-effective, and we were able to show that T-EDTA significantly reduced total research costs and improved animal welfare.
摘要：
背景：中线相关血流感染是肠衰竭儿童和使用肠外营养（PN）的动物研究中的主要问题。在接受PN的新生仔猪中，我们比较了脓毒症,线闭塞,线路替换,死亡率,以及使用和不使用4％-乙二胺四乙酸四钠（T-EDTA）锁定溶液的成本。
方法：我们对参加14天独家PN（TPN）试验或7天短肠综合征（SBS）试验的仔猪进行了回顾性审查，开始T-EDTA之前和之后。每天用1-ml溶液锁线2小时(T-EDTATPN，n=17；T-EDTASBS，n=48），并与我们以前使用每天两次1.5毫升肝素冲洗的护理标准进行比较（CONTPN，n=34；CONSBS，n=48）。每天两次检查线路通畅和败血症的体征。尽可能更换颈静脉导管用于闭塞。人道终点用于对抗生素治疗无反应的脓毒症或未解决的导管闭塞。
结果：与CON相比，使用T-EDTA减少脓毒症，TPN显着（P=0.006），SBS仔猪有趋势（P=0.059）。在TPN研究中，需要线路改变的线路闭塞减少了15%(P=0.16)，T-EDTASBS仔猪未发生线闭塞。
结论：在我们的新生仔猪研究中，使用T-EDTA锁定溶液减少脓毒症，虽然没有统计学意义，减少需要换行的闭塞。考虑到动物研究的费用，添加锁定解决方案必须具有成本效益，我们能够证明T-EDTA显著降低了总研究成本并改善了动物福利。
方法：我们对参加14天独家PN（TPN）试验或7天短肠综合征（SBS）试验的仔猪进行了回顾性审查，开始T-EDTA之前和之后。每天用1-ml溶液锁线2小时(T-EDTATPN，n=17；T-EDTASBS，n=48），并与我们以前使用每天两次1.5毫升肝素冲洗的护理标准进行比较（CONTPN，n=34；CONSBS，n=48）。每天两次检查线路通畅和败血症的体征。尽可能更换颈静脉导管用于闭塞。人道终点用于对抗生素治疗无反应的脓毒症或未解决的导管闭塞。
结果：与CON相比，使用T-EDTA减少脓毒症，TPN显着（P=0.006），SBS仔猪有趋势（P=0.059）。在TPN研究中，需要线路改变的线路闭塞减少了15%(P=0.16)，T-EDTASBS仔猪未发生线闭塞。
结论：在我们的新生仔猪研究中，使用T-EDTA锁定溶液减少脓毒症，虽然没有统计学意义，减少需要换行的闭塞。考虑到动物研究的费用，添加锁定解决方案必须具有成本效益，我们能够证明T-EDTA显著降低了总研究成本并改善了动物福利。
