{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T22:51:49Z","timestamp":1785538309385,"version":"3.56.0"},"reference-count":44,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T00:00:00Z","timestamp":1717545600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aspenjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Parenter Enteral Nutr"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Selection of central venous catheter (CVC) lock solution impacts catheter mechanical complications and central line\u2013associated bloodstream infections (CLABSIs) in pediatric patients with intestinal failure. Disadvantages of the current clinical standards, heparin and ethanol lock therapy (ELT), led to the discovery of new lock solutions. High\u2010risk pediatric patients with intestinal failure who lost access to ELT during a recent shortage were offered enrollment in a compassionate use trial with 4% tetrasodium EDTA (T\u2010EDTA), a lock solution with antimicrobial, antibiofilm, and antithrombotic properties.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a descriptive cohort study including 14 high\u2010risk pediatric patients with intestinal failure receiving 4% T\u2010EDTA as a daily catheter lock solution. CVC complications were documented (repairs, occlusions, replacements, and CLABSIs). Complication rates on 4% T\u2010EDTA were compared with baseline rates, during which patients were receiving either heparin or ELT (designated as heparin\/ELT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients initiated 4% T\u2010EDTA at the time they were enrolled in the compassionate use protocol. Use of 4% T\u2010EDTA resulted in a 50% reduction in CVC complications, compared with baseline rates on heparin\/ELT (incidence rate ratio: 0.50; 95% CI, 0.25\u20131.004; <jats:italic>P<\/jats:italic>\u2009=\u20090.051).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In a compassionate use protocol for high\u2010risk pediatric patients with intestinal failure, the use of 4% T\u2010EDTA reduced composite catheter complications, including those leading to emergency department visits, hospital admissions, additional procedures, and mortality. This outcome suggests 4% T\u2010EDTA has benefits over currently available lock solutions.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jpen.2644","type":"journal-article","created":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T03:14:36Z","timestamp":1717557276000},"page":"624-632","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Administration of 4% tetrasodium EDTA lock solution and central venous catheter complications in high\u2010risk pediatric patients with intestinal failure: A retrospective cohort study"],"prefix":"10.1002","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1373-2388","authenticated-orcid":false,"given":"Thomas I.","family":"Hirsch","sequence":"first","affiliation":[{"name":"Vascular Biology Program, Department of Surgery Boston Children's Hospital Boston Massachusetts USA"},{"name":"Harvard Medical School Boston Massachusetts 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Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"McClelland","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Nutrition Boston Children's Hospital Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra N.","family":"Carey","sequence":"additional","affiliation":[{"name":"Harvard Medical School Boston Massachusetts USA"},{"name":"Division of Gastroenterology, Hepatology, and Nutrition Boston Children's Hospital Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0431-896X","authenticated-orcid":false,"given":"Kathleen M.","family":"Gura","sequence":"additional","affiliation":[{"name":"Harvard Medical School Boston Massachusetts USA"},{"name":"Division of Gastroenterology, Hepatology, and Nutrition Boston Children's Hospital Boston Massachusetts USA"},{"name":"Department of 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