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Transcutaneous iodine absorption in infants undergoing cardiac operation
I M Mitchell1, J C Pollock, M P Jamieson
1Department of Cardiac Surgery, Royal Hospital for Sick Children, Yorkhill, Glasgow, Scotland.
The Annals of Thoracic Surgery
|November 1, 1991
Summary
Topical povidone-iodine antiseptic use in infants undergoing cardiac surgery can lead to significant iodine absorption. This absorption may cause adverse effects, highlighting the need for careful antisepsis policies in neonates.
Area of Science:
- Neonatal care
- Pediatric surgery
- Pharmacokinetics
Background:
- Povidone-iodine is a common topical antiseptic.
- Transcutaneous absorption of iodine from povidone-iodine can cause adverse effects in neonates and burn patients.
- Infants have permeable skin, increasing absorption risk.
Purpose of the Study:
- To investigate the extent of transcutaneous iodine absorption in infants undergoing cardiac procedures.
- To assess the impact of povidone-iodine skin preparation on plasma iodine concentrations in infants.
Main Methods:
- Studied 17 infants (<3 months old) undergoing cardiac or thoracic procedures.
- 15 infants received povidone-iodine skin preparation on 20-30% of body surface area.
- Plasma total iodine concentrations were measured preoperatively and at 6, 12, 18, and 24 hours post-application.
Main Results:
- Plasma total iodine concentrations increased fourfold in infants prepared with povidone-iodine.
- Increases were statistically significant at multiple time points up to 24 hours.
- No significant increase in plasma iodine was observed in infants not exposed to povidone-iodine.
Conclusions:
- Povidone-iodine skin preparation in infants can lead to substantial transcutaneous iodine absorption.
- The findings suggest potential risks of iodine toxicity (e.g., renal failure, thyroid suppression).
- Re-evaluation of topical antisepsis policies for infants is warranted.