Use of Chlorhexidine in NICU

[JACK]

Dear fellow 99nicu-ites ! A Warm Hello !!

I wanted to know how many of you are using chlorhexidine in your NICUs? In what form? What packaging? At which steps in the newborn care? Any contra-indications for use? Do you use chlorhexidine alone or with isopropyl alcohol ?

We are using chlorhexidine swab sticks while inserting central lines.

We recently came across chlohexidine wipes but do not know if they have a role in NICU.
I was alarmed when I read this :Doctors-warned-using-antiseptic-wipes-premature-babies-infants-suffer-burns-effects

Have you come across such burns in your unit? What precautions do you take?

[Stefan Johansson]

We use chlorhexidine (5 mg/ml with alcohol) for infants >1500 gram. In practical terms, that means infants ≥32 weeks.For very preterm infants (<32 weeks) we use chlorhexidine solution (2 mg/ml without alcohol).

[matok]

There has been some disturbing Information concerning the misuse of chlorhexidine 7% solution as eye drops in certain communities of Yobe state, Nigeria leading to ophthalmic complications. This is in contrast to the nationally recommended 4% chlorhexidine gel for the cord care protocol. Apparently, the 7% chlorhexidine solution is packaged like an eye drop. It was given  to mothers at the primary health care centres across the state after delivery to be used for cord care. It is not clear why some mothers decided to apply it to the eyes of their newborns, but it is believed that the mother were not adequately educated on its usage. The Federal ministry of Health and the National Association of Neonatal Medicine in the country have already swung into action to stop this unfortunate incidence. http://saharareporters.com/2015/09/09/chlorhexidine-solution-imported-unicef-turns-5-kids-blind-nigeria

Edited September 20, 2015 by matok

[JACK]

@matok..The packaging is to blame. Even I thought they were eye drops...because they look like eye drops.

[marime65]

¿Alguna referencia bibliográfica de este tema?

[Stefan Johansson]

¿Alguna referencia bibliográfica de este tema?

Que ?

[JACK]

¿Alguna referencia bibliográfica de este tema?

http://www.ncbi.nlm.nih.gov/pubmed/?term=chlorhexidine+neonate+injury

 

[Aymen Eshene]

i want to ask about chlorohexidine powder , is there any role for it in nicu ?

[Kiran Kumar]

Please see the guidance from MHRA, UK. Injuries have been reported even with the lower concentration (0.5% & 2.0%) solutions containing alcohol. we also had some injuries but milder ones -erythema in small babies when using chlohex. we were cleaning with saline after chlorhex to prevent injuries.  this practice may compromise the antiseptic action of chlorhex.  but is there any alternative?

 

Chlorhexidine-solutions_risk-of-chemical-burn-injury-to-skin-in-premature-infants_BAPS.pdf