A literature review of selection of appropriate antiseptics when inserting intravenous catheters in premature infants: The challenge in neonatal intensive care unit
Imane Bagheri1, Bahare Fallah2, Atena Dadgari3, Azam Shirinabadi Farahani4, Naiire Salmani5
1 Department of Medical - Surgical, PhD Student in Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
2 Department of Medical - Surgical, Nursing and Midwifery Faculty, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
3 Department of Psychology, Nursing Faculty, Meybod Nursing School, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
4 Department of Pediatric and Neonatal Intensive Care Nursing, Nursing and Midwifery Faculty, Nursing and Midwifery School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
5 Depatment of Pediatrics, Nursing Faculty, Meybod Nursing School, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Prof. Naiire Salmani
Nursing Faculty, Meybod Nursing School, Shahid Sadoughi University of Medical Sciences, Yazd
Source of Support: None, Conflict of Interest: None
Background: Reducing or preventing bloodstream infection caused by invasive intravenous catheterization, emphasizes the use of an effective topical antiseptics agent; however, because of the flaw in the evidence available regarding the choice of safe antiseptic to use on infants' skin under 2 months this issue remains controversial. The aim of this study was to investigate the types of antiseptics commonly used in neonatal intensive care units, consumption criteria and side effects of consumption and the effects of using antiseptics in premature infants. Methods: In this review, the total number of articles in PubMed, Scopus and ScienceDirect databases since 2010 were searched; titles and abstracts to identify relevant articles have been identified and 14 of the 48 searched articles were finally reviewed. Results: The review articles showed that different antiseptic-including chlorhexidine (CHG) 2% with alcohol base, pure CHG (in different density - 0.05%–2%), povidone-iodine 10%, isopropyl alcohol, 70% alcohol are used when inserting intravenous catheters in premature infants. Cutaneous side effect, systemic absorption and transient hyperthyroidism were reported as common side effects. Weight or age was criteria reported for antiseptic use. Various studies have been conducted to compare the effects of antiseptic with each other and different results have been reported.
Conclusion: There is a paucity of evidence-based consensus guidelines for the use of appropriate antiseptic for preparing the skin before placing the intravenous catheter in preterm babies. Further research and publications are required, which will help reduce the risk of line related hospital-acquired infections.