Reduction of Central Line–Associated Bloodstream Infections and Line Occlusions in Pediatric Intestinal Failure Patients Receiving Long‐Term Parenteral Nutrition Using an Alternative Locking Solution, 4% Tetrasodium Ethylenediaminetetraacetic Acid
Bibliographic record
Abstract
BACKGROUND: Patients with intestinal failure (IF) are dependent on parenteral nutrition (PN), however, they are at risk of central line-associated bloodstream infections (CLABSIs) and line complications. Four-percent tetrasodium ethylenediaminetetraacetic acid (EDTA) solution is an effective nonantibiotic, antimicrobial, antibiofilm, and anticoagulant agent. Our objective was to determine 4% tetrasodium EDTA efficacy in preventing CLABSIs and reducing line occlusions in pediatric IF patients. METHODS: We conducted a retrospective cohort study of patients managed at 2 tertiary Canadian pediatric centers between April 2016 and December 2018 who received 4% tetrasodium EDTA solution under the brand name Kitelock. Data were collected for 12 months pre and post-Kitelock. CLABSIs and alteplase administration were compared using a Wilcoxon matched-pairs signed-rank test. Data were reported as medians and frequencies. RESULTS: Twenty patients were included (10 boys; median age, 83 months [range, 8-232 months]). The rate of CLABSIs before 4% tetrasodium EDTA was 2.7+4 per 1000 catheter days. Patients received 4% tetrasodium EDTA for a median of 365 (278-365) days, with no infections in the 12 months post-therapy (P = .002). Median rates of occlusive episodes for the entire cohort before 4% tetrasodium EDTA were 0 (0-5.0) and 0 (0-2.0) after starting therapy (P = .018). In patients with previous occlusions (n = 9), the median episodes of alteplase use previously was 5.5 (2.7-19.2) compared with 2.7 (0-2.7) (P = .018). CONCLUSIONS: Our preliminary findings suggest 4% tetrasodium EDTA solution is effective in reducing CLABSIs and catheter occlusions in pediatric patients with long-term central-access.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".