Quantifying exposure to chlorhexidine from decontamination of peripheral intravenous injection ports

Background Annually, almost 2 billion peripheral intravenous cannulas (PIVCs) are placed worldwide. In response to concerns of infectious complications, chlorhexidine is increasingly utilised for maintenance decontamination of PIVC injection ports. Concomitantly, the allergenic potential of chlorhex...

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Bibliographic Details
Published in:Acta anaesthesiologica Scandinavica 2023-03, Vol.67 (3), p.356-363
Main Authors: Doane, Matthew A., Kwong, Christopher, Proschogo, Nicholas
Format: Article
Language:English
Subjects:
Allergic reactions
allergy
Anaphylaxis
Case reports
Catheterization
Catheterization, Peripheral
Chlorhexidine
chlorhexidine alcohol wipes
chlorhexidine entrainment
chlorhexidine injection
Cleaning
Complications
Decontamination
Decontamination - methods
Entrainment
Ethanol
Exposure
Humans
Hypersensitivity
immunology
Injection
injection port
Injections, Intravenous
Intravenous administration
intravenous cannula
Liquid chromatography
Maintenance
Mass spectrometry
Mass spectroscopy
Mean
needleless hub
Risk factors
Variance analysis
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Summary:Background Annually, almost 2 billion peripheral intravenous cannulas (PIVCs) are placed worldwide. In response to concerns of infectious complications, chlorhexidine is increasingly utilised for maintenance decontamination of PIVC injection ports. Concomitantly, the allergenic potential of chlorhexidine exposures has been highlighted by several case reports, implicating it as a trigger when used for this seemingly innocuous process. Given how widespread this application is, elucidating potential chlorhexidine exposure is needed to gauge its risks and benefits. Objective To examine and quantify if chlorhexidine is entrained when used for PIVC injection port cleaning. Methods Twenty benchtop PIVC set‐ups were cleaned with 2% chlorhexidine and 70% alcohol wipes, following three different pragmatic protocols. Each set‐up was injected with 10 ml ultrapure water, and samples tested by liquid chromatography‐electrospray tandem mass spectrometry for entrained chlorhexidine. Results Chlorhexidine was detected in every sample. Mean concentrations and standard deviations from each protocol were 41.47 ppb (4.08), 54.76 ppb (17.46), and 65.84 ppb (7.01). One‐way ANOVA indicated a statistical difference between at least two groups (df = 2, F = 24.11, p 
ISSN:0001-5172
1399-6576
DOI:10.1111/aas.14189