The risks of methemoglobinemia with the use of two antimicrobials in low birth weight infants
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Dr. Denise J. Maguire, PhD, RN, CNL, FAAN
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- Delta Beta at-Large
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The purpose of this study was to determine the degree of risk of methemoglobinemia and extent of skin breakdown when 0.5% chlorhexidine was used as a topical antimicrobial in a population of low birth weight (LBW) infants. Differences in the measures of methemoglobin (MetHb) levels and observed appearance of the skin for breakdown were sought. As the first investigation of the risks of the use of 0.5% chlorhexidine in LBW infants, the study employed an experimental design of repeated measures. The use of chlorhexidine 0.5% was compared with the conventional practice of using 70% isopropyl alcohol to test the hypothesis that MetHb levels are significantly higher in LBW infants treated with chlorhexidine than those treated with isopropyl alcohol. Daily skin assessments using the Scale for Integrity of Neonatal Skin (SINS) were collected to test the hypothesis that the skin integrity scores of LBW infants treated with chorhexidine are significantly higher than those treated with isopropyl alcohol. Surface electrical capacitance (SEC) measurements (which positively correlate with transepidermal water loss) were taken to test the hypothesis that SEC is correlated with MetHb levels. Data were collected on ten LBW infants who were less than 29 days old, with birth weight between 750 and 1500 grams. Data collection began at no later than 7 days of age and were collected daily throughout the neonatal period until the subjects were 28 days old. There was no statistically significant difference in means of MetHb levels between those infants treated with alcohol and those treated with chlorhexidine (F = 3.53, p = .0621). Subjects treated with chlorhexidine did not have more skin breakdown than those treated with isopropyl alcohol (F = 1.87, p = 0.1724). There was no correlation between the methemoglobin levels and surface electrical capacitance (r = .0529, p = 0.2638). Although methemoglobin levels were not statistically higher in the treatment group, they were slightly higher than those in the control group. The researcher advises cautious use of 0.5% chlorhexidine as a topical antimicrobial in a population of low birth weight infants greater than 750 grams, and only with diligent attention to its removal after 30 seconds.
This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 9976573; ProQuest document ID: 304589879. The author still retains copyright.
This item has not gone through this repository's peer-review process, but has been accepted by the indicated university or college in partial fulfillment of the requirements for the specified degree.
Type | Dissertation |
Acquisition | Proxy-submission |
Review Type | None: Degree-based Submission |
Format | Text-based Document |
Evidence Level | Quasi-Experimental Study, Other |
Research Approach | Pilot/Exploratory Study |
Keywords | Infant Blood Disorders; Infant Care; Obstetric Nursing |
CINAHL Subject(s) | Methemoglobinemia--Chemically Induced--In Infancy and Childhood; Antiinfective Agents, Local--Adverse Effects--In Infancy and Childhood; Chlorhexidine--Adverse Effects--In Infancy and Childhood; Methemoglobinemia--Chemically Induced; Antiinfective Agents, Local--Adverse Effects; Chlorhexidine--Adverse Effects; Methemoglobinemia; Antiinfective Agents, Local; Chlorhexidine |
Grantor | University of Florida |
Advisor | Smyth, Kathleen A. |
Level | PhD |
Year | 2000 |
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