Department of Pediatrics, IWK Health Centre, Dalhousie University, Halifax, Canada.
Am J Perinatol. 2019 Jan;36(2):141-147. doi: 10.1055/s-0038-1661406. Epub 2018 Jun 26.
This article assesses the degree of variability in the current practice of skin antiseptics used in Canadian neonatal intensive care units (NICUs) and different experiences related to each antiseptic used.
An anonymous survey was distributed to a clinical representative of each of the 124 Canadian level II and level III NICUs.
One hundred and two respondents (82.2%), representing all Canadian provinces, completed the survey. Chlorhexidine gluconate with/without alcohol was the antiseptic most used (96%) and the antiseptic with the highest reported adverse effects (68% reported skin burns/breakdown). Other antiseptics used include povidone-iodine (35%) and isopropyl alcohol (22%). Specific guidelines for antiseptic use were available in only 50% of the units with many NICUs lacking gestational and/or chronological age restrictions. Only 23% of responders believed that there was awareness among health care providers of the adverse effects of antiseptics used. Less than half (43%) were completely satisfied with the antiseptics used in their units.
Chlorhexidine gluconate is the most commonly used antiseptic in Canadian NICUs. The high number of associated adverse effects and the lack of guidelines regulating antiseptic use are of concern. Large clinical trials are urgently needed to guide practice and improve the safety of antiseptics.
本文评估了加拿大新生儿重症监护病房（NICU）中皮肤消毒剂使用的当前实践的变异性程度，以及与每种消毒剂使用相关的不同经验。
向加拿大 124 个二级和三级 NICU 的每个临床代表分发了一份匿名调查。
102 名（82.2%）代表加拿大所有省份的受访者完成了调查。葡萄糖酸氯己定（含/不含酒精）是使用最广泛的消毒剂（96%），报告的不良影响最高（68%报告皮肤烧伤/破裂）。其他使用的消毒剂包括聚维酮碘（35%）和异丙醇（22%）。只有 50%的单位有具体的消毒剂使用指南，许多 NICU 缺乏胎龄和/或年龄限制。只有 23%的受访者认为医护人员意识到所使用消毒剂的不良影响。不到一半（43%）的人对其单位使用的消毒剂完全满意。
葡萄糖酸氯己定是加拿大 NICU 中最常用的消毒剂。大量相关不良影响以及缺乏规范消毒剂使用的指南令人担忧。迫切需要开展大规模临床试验，以指导实践并提高消毒剂的安全性。
