PEDIATRICS Vol. 77 No. 4 April 1986, pp. 500-506
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Benzyl Alcohol Toxicity: Impact on Mortality and Intraventricular Hemorrhage Among Very Low Birth Weight Infants

Janet L. Hiller MD1, Gerda I. Benda MD1, Mohammadtaglii Rahatzad MD1, James R. Allen MD1, David H. Culver PhD1, Christina V. Carlson BS1, and John W. Reynolds MD1

1 From the Departments of Pediatrics and Radiology, Oregon Health Sciences University, Portland, and Centers for Disease Control, Public Health Service, US Department of Health and Human Services, Atlanta

Benzyl alcohol preservative in intravascular flush solutions has been reported to cause neurologic deterioration and death in very low birth weight infants. Following the widespread discontinuation of the use of such solutions in newborns, scattered reports of decreased mortality and decreased incidence of intraventricular hemorrhage among small premature infants appeared in the pediatric literature. To better assess the true impact of benzyl alcohol toxicity in this group of infants, we undertook a detailed review of the medical records of all babies <1,250 g birth weight admitted to our neonatal intensive care unit for 13 months before and 13 months after the use of solutions containing benzyl alcohol was stopped. Significant decreases were found in both mortality rate (from 80.7% to 45.7%) and incidence of grade III/IV intraventricular hemorrhage (from 46% to 19%) among infants <1,000 g birth weight who did not receive the preservative compared with those who did. No significant changes were found in several other prenatal factors that could have contributed to this improvement in survival. We conclude that benzyl alcohol toxicity contributed significantly to both mortality and the occurrence of major intraventricular hemorrhage among infants weighing <1,000 g at birth and that solutions containing benzyl alcohol should never again be used in the care of such infants.

Key Words: benzyl alcohol • neonatal mortality • very low birth weight infant • intraventricular hemorrhage

Submitted on May 24, 1985
Accepted on August 3, 1985




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