[Respiratory distress in three newborns after mask disinfection with Endosporine. Probable role of glutaraldehyde].
BACKGROUND
Disinfectants for medical devices are uncommonly a cause of iatrogenic adverse effects. Nevertheless, when misused, they can induce severe complications. Three cases of acute respiratory distress in newborns probably induced by glutaraldehyde are reported.


METHODS
Three children born by Caesarean section between 8 and 19 May 1999 in the same hospital presented acute respiratory distress requiring hospitalization in the neonatal intensive care unit; one child was premature. The clinical appearance, which was initially normal, deteriorated with a respiratory distress in 30 to 60 minutes. Recovery was uneventful in all cases. The diagnosis considered was a hyaline membrane disease. The enquiry conducted after this cluster onset identified, as a main contributing factor, the disinfection procedure recently introduced in the surgical theater.


CONCLUSIONS
Review of toxicologic data on glutaraldehyde shows this is a highly irritating chemical for the respiratory tract, even at low concentrations. Clinical and radiologic features in these three neonates are compatible with a pulmonary sub-edema on an immature alveolar setting. The hypothesis proposed is that glutaraldehyde, the active ingredient of the biocidal formula used to disinfect the respiratory masks, was massively desorbed from the rubber and foam of which masks are made.
Testud
F
F
Centre antipoison, hôpital Edouard-Herriot, Lyon, France.
Bubnic
A
A
Valancogne
A
A
Assaf
G
G
Vray
C
C
Cottin
X
X
Bourgeois
J
J
Descotes
J
J
D004202:Disinfectants / Q000009:adverse effects*; D017743:Equipment Reuse; D005260:Female; D005976:Glutaral / Q000009:adverse effects*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D008297:Male; D008397:Masks / Q000382:microbiology*; D012127:Respiratory Distress Syndrome, Newborn / Q000139:chemically induced*
D004202:Disinfectants; D005976:Glutaral
Détresse respiratoire chez trois nouveau-nés après désinfection des masques par l'Endosporine. Rôle probable du glutaraldéhyde.