RESUMO
Over a 4-month period, all infants admitted to the well-baby nursery were enrolled in a prospective study designed to compare cord separation times between infants treated with triple dye once, followed by daily alcohol application, to infants treated with daily alcohol application alone. Follow-up phone calls were done 7 days after discharge, with weekly calls until cord separation occurred. The objective was to determine whether the umbilical cord care regimen of triple dye followed by alcohol has an advantage over the alternative regimen of alcohol alone, with regard to cord separation, parenting, or healthcare caretaker preferences. In total, 634 infants were enrolled, with 599 infants (94%) completing the study. Infants in the alcohol alone group had a shorter cord separation time by 3 days (10 versus 13 days) (p < 0.0001). There was no reported increase in infection, and monetary savings were noted. We conclude that alcohol applied once a day appears to be a safe and effective means of promoting cord detachment.
Assuntos
Álcoois/uso terapêutico , Anti-Infecciosos Locais/uso terapêutico , Violeta Genciana/uso terapêutico , Proflavina/uso terapêutico , Compostos de Amônio Quaternário/uso terapêutico , Cordão Umbilical/efeitos dos fármacos , Infecção dos Ferimentos/prevenção & controle , Administração Tópica , Distribuição de Qui-Quadrado , Combinação de Medicamentos , Feminino , Seguimentos , Humanos , Recém-Nascido , Masculino , Estudos Prospectivos , Valores de Referência , Estatísticas não Paramétricas , Resultado do Tratamento , Cicatrização/efeitos dos fármacos , Cicatrização/fisiologiaRESUMO
OBJECTIVE: Extremely low birth weight (ELBW) infants often acquire catheter-related infections (CRIs) when a percutaneously inserted central catheter (PICC) is used for parenteral nutrition or drug administration. Our objective was to compare the incidence of CRIs after we established a "PICC Maintenance Team" for the proactive management--compared to expectant management--of these lines. STUDY DESIGN: We did a prospective collection and analysis of catheter-related sepsis data over a 15-month period from February 1, 1998 through May 1, 1999. Eligible patients included all neonates weighing <1000 g at birth. RESULTS: There was a significantly decreased incidence of CRIs, to a rate of 7.1%, or 5.1/1000 catheter days (p<0.05). CONCLUSION: "Proactive" management of PICC, significantly reduced the incidence of CRIs. The reduction in infection rate is estimated to save 180 hospitalized patient days/100 very low birth weight neonates, with a concomitant savings in morbidity and medical expense.
