A comparison of catheter lock solutions and associated complications in pediatric intestinal failure patients
Bibliographic record
Abstract
Background: Children with intestinal failure (IF) receiving parenteral nutrition (PN) are at risk for central venous catheter (CVC) associated complications including infection, occlusion, and breakage. A variety of catheter locks have been used to preserve patency and prevent infection when catheters are not in use. Taurolidine (T) and Ethylenediaminetetraacetic acid (EDTA) locks have antimicrobial and anticoagulant properties; however, superiority of one is unclear. Material and Methods: A multicenter, retrospective review of children with IF on PN and receiving care from an Intestinal Rehabilitation team (2017-2022) was performed. Children using T or EDTA locks were included, and those with incomplete records were excluded. Rates of central line associated bloodstream infections (CLABSIs), occlusions, and breakages were compared and reported as mean events per 1000 catheter days (CDs) with standard errors (SE). Analysis was performed using the Mann-Whitney test. Results: 48 children (4 months-16 years) were included for a total of 112 catheters, mostly single lumen, peripherally inserted central catheters (76 %) or tunneled CVCs (21 %). T and EDTA locks accounted for 22,530 CDs and 7913 CDs respectively. Rates of CLABSIs did not differ between groups (T 1.5/1000 CDs, SE=0.79, and EDTA 0.4/1000 CDs, SE=0.41, p = 0.17). CVC occlusions requiring catheter replacement were similar (2.3 vs. 1.3 per 1000 CDs, p = 1.00) as were fractures requiring replacement (4.0 vs. 2.1 per 1000 CDs, p = 0.73). Conclusion: Taurolidine and EDTA locks are similarly effective in preventing infections and equally likely to be associated with occlusion or breakage. Both are suitable for children with IF on long-term PN.
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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 | 0.001 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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".