08/03/2026
ORIGINAL ARTICLE
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A comparison between sodium bicarbonate and ethanol for central line locks in pediatric patients with intestinal failure
Kate McNevin, Beatrice E. Rosete, Shiho Fukasawa, Xing Wang, Patrick J. Javid, Danielle R. Wendel
First published: 09 March 2026 https://doi.org/10.1002/jpn3.70393Digital?utm_source=fb_page&utm_medium=Journal+of+Pediatric+Gastroenterology+and+Nutrition&utm_campaign=publer Object Identifier (DOI) view metrics
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Kate McNevin and Beatrice E. Rosete are co-first authors.
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Abstract
Objectives
Children with intestinal failure (IF) require central venous catheters for parenteral nutrition and are at risk for central line associated blood stream infections (CLABSI). Prophylactic ethanol lock therapy has historically been used for CLABSI prevention. A recent national shortage of ethanol necessitated exploring an alternative lock strategy using sodium bicarbonate. This study sought to assess the impact of ethanol and sodium bicarbonate locks on CLABSI rates in children with IF.
Methods
A retrospective cohort study was conducted in pediatric patients with IF 0–21 years of age followed by the Intestinal Rehabilitation Program at Seattle Children's Hospital who received ethanol or sodium bicarbonate locks from 2018 to 2023. Rates of CLABSI, line repair, line replacement and line occlusion were calculated per 1000 catheter days. Variables were compared between the two lock groups using the Mann–Whitney U or Fisher's exact tests.
Results
Fifty-five patients were identified including 19 children who received ethanol locks and 36 with sodium bicarbonate locks. Rates of CLABSI were similar between the ethanol and sodium bicarbonate lock cohorts (2.03 [3.46], 1.59 [2.83]; p = 0.617(mean [standard deviation]). The sodium bicarbonate group had a lower rate of line replacement (2.21 [1.17–3.84], 0.00 [0.00–1.73]; p = 0.01, median [interquartile range]) and trended toward a lower rate of line repair, (1.94 [0.00–4.15], 1.07 [0.00–1.61]; p = 0.23).
Conclusions
This study demonstrates that sodium bicarbonate locks are a safe and effective alternative to ethanol locks for pediatric patients with IF with equivalent rates of CLABSI and decreased rates of line replacements and repairs.
Highlights
What is Known
Pediatric patients with intestinal failure (IF) require central lines for nutrition support and these lines increase risk of morbidity and mortality due to central line associated blood stream infections (CLABSI) and loss of central access which may result in the need for intestinal transplantation.
To prevent infections, ethanol locks have been used but are no longer widely available.
What is New
Sodium bicarbonate locks have shown promise, but data is limited. We found that sodium bicarbonate locks were associated with equivalent CLABSI rates and decreased rates of catheter occlusions and line repairs or replacements in this population.
Sodium bicarbonate locks are a safe and effective alternative to ethanol locks in children with IF.
DOI Not Found 10.1002/jpn3.70393Digital This DOI cannot be found in the DOI System. Possible reasons are: The DOI is incorrect in your source. Search for the item by name, title, or other metadata using a search engine. The DOI was copied incorrectly. Check to see that the string includes all the ch...
