Skin antisepsis with 0.05% sodium hypochlorite before central venous catheter insertion in neonates: A 2-year single-center experience


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Abstract

HighlightsThe study evaluates the effects of skin antisepsis with 0.05% sodium hypochlorite in neonates before central venous catheter placement.There were no signs of sodium hypochlorite-related skin toxicity in any infant.9 cases of bloodstream infections associated with central lines were detected (5.4 per 1000 catheter-days).Our experience suggests that this antiseptic is presumptively non–irritant for skin in neonates, including Extremely Low Birth Weight infants.These findings could form the basis for future trials to evaluate the efficacy and skin tolerance of 0.05% sodium hypochlorite in comparison to the antiseptics commonly used in NICUs.Aim:The study reports a 2-year single-center experience of the practice of skin antisepsis using a 0.05% sodium hypochlorite solution before central venous catheter placement in neonates.Methods:Eligible subjects included any hospitalized neonate who needed a central line for at least 48 hours. Infants were excluded if they had a generalized or localized skin disorder. An ad hoc Excel (Microsoft Corp, Redmond, WA) file was used to record the data from each patient. The catheter sites were monitored daily for the presence of contact dermatitis. Central line-associated bloodstream infection was diagnosed according to Centers for Disease Control and Prevention definition.Results:One hundred five infants underwent central venous catheter placement and were enrolled. A total of 198 central lines were inserted. The median gestational age was 31 weeks (range, 23-41 weeks) and median birth weight was 1,420 g (range, 500-5,170 g). There were no signs of 0.05% sodium hypochlorite-related skin toxicity in any infant. Of 198 catheters (1,652 catheter-days) prospectively studied, 9 were associated with bloodstream infections (5.4 per 1,000 catheter-days).Conclusion:During the observation period, no local adverse effects were observed suggesting that 0.05% sodium hypochlorite may be a safe choice in this context.

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