471 Short Term Outcomes with Use of Chlorhexidine Gluconate (CHG) and Povidone-Iodine (PI) in VLBWI with Percutaneously Placed Central Venous Catheters

Abstract

Background and aims: CHG's use as a skin antiseptic in neonates is limited because of concerns about systemic absorption and potential side-effects. No chlorhexidine-based antiseptic has been approved by the FDA for neonatal IV catheter placement. We compared the short-term risks of using CHG versus PI as an antiseptic for percutaneously placed central venous catheters (PPCVCs) in VLBWI. Methods: The records of VLBWI admitted to the NICU at Miami Children's Hospital from 2004-8 were reviewed. Initially, PI was used. After a change in hospital guidelines, CHG replaced PI. Every 10 days the site was re-cleansed with the same antiseptic. Outcomes compared: BPD, NEC, IVH, PVL, ROP, failed hearing test (FHT), length of stay (LOS) and death in infants with lines placed during the first 30 days of life. Results: PPCVCs were inserted in 187 infants (CHG=95, PI=92). Birthweight, gestational age, gender, total duration of PPCVCs and LOS were similar between CHG and PI groups. The mortality rates in CHG (12.8%) and PI (16.3%) were similar (p=0.54). COMORBIDITIES: PI group (%), CHG group (%), p value Table Conclusions: The use of CHG as an antiseptic for PPCVCs in VLBWI did not increase the risk of major adverse short-term outcomes and mortality when compared to the use of PI. Although this preliminary data is encouraging, prospective studies are needed to confirm its safety.