Pilot Study of the Safety of a Daily Ethanol Lock for Urinary Catheters in Critically Ill Children

Children's Healthcare of Atlanta

Status and phase: Completed; Phase 1

Conditions: Complication of Urinary Catheter

Treatments: Drug: Ethanol Lock

Study type: Interventional

Funder types: Other

Identifiers

NCT01865708

Ethanol Lock, Safety

Details and patient eligibility

About

Hypothesis 1: Blood alcohol concentration will be <25 mg/100ml (equivalent to a blood alcohol concentration of <0.025%) after a 1 hour urinary catheter ethanol lock.

Hypothesis 2: Daily urinary catheter ethanol locks will not result in increased hematuria or increased urinary white cells.

Full description

This study involves a confirmatory/refuting approach to the above stated hypothesis. The investigators will test this hypothesis by addressing the following aims/objectives:

Specific Aim 1:

Quantify blood alcohol levels after a 1 hour 74% ethanol lock in urinary catheters utilized in the Pediatric Intensive Care Unit.

Specific Aim 2:

Compare cellular components in urinalyses after the introduction of the ethanol locks.

Potential study subjects will be recruited from the Children's Healthcare of Atlanta - Egleston Pediatric Intensive Care Unit. Children that are anticipated to have an indwelling urinary catheter for >48 hours will be included. For this pilot study, the investigators will enroll 10 patients. Subject ages will range from 6 months to 17 years. Children who are on a service other than Critical Care Medicine will have clearance from the primary team prior to approaching for enrollment. The consent process will take place prior to or during the initial 24 hours of urinary catheter placement.

Enrollment: 10 patients

Sex: All

Ages: 6 months to 17 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age: 6 months - 17 years
• Urinary catheter placed at Children's Healthcare of Atlanta
• Anticipated urinary catheter need for > 48 hours
• Parent or legal guardian (or patient when applicable) consent for enrollment.

Exclusion criteria

• 18 yo or older.
• Urosepsis at time of study enrollment
• Known bladder or genitourinary abnormalities
• Chronic bladder drainage regimen
• Urologic surgeries (as part of the current admission)
• Medical urgency preventing timely administration of the consenting process, or any condition that, in the opinion of the attending physician, would place the patient at undue risk by participating.
• Anuria or oliguria (<0.5 cc/kg/hr averaged over the previous 12 hours)
• Other technical considerations that would prevent the timely acquisition of sufficient samples such as (but not limited to) absence of a study team member.
• Parent or legal guardian (or patient when applicable) refuses to sign informed consent.

Trial design

Primary purpose: Other

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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10 participants in 1 patient group

Ethanol lock

Other group

Description:

Ethanol lock, utilizing 74% ethanol, will begin within 24 hours of urinary catheter placement. The lock will be done every 24 hours for 1 hour. The volume that will be instilled depends upon the fill volume of the catheter, which is imprinted by the manufacturer on each catheter. Once the alcohol is in the catheter, the proximal end of the catheter will be clamped for 1 hour. After the 1 hour dwell time, the clamp will be removed and the alcohol in the lumen of the catheter will be flushed out by the patient's own urine output.

Treatment:

Drug: Ethanol Lock