[Iodine burden in premature infants in roentgenologically controlled positioning of central venous silastic catheters]
Related Experiment Videos
Insights
Iodine-containing contrast agents given to sick preterm infants can cause transient hypothyroxinemia. While severe hypothyroidism was not observed, caution is advised when using these agents in premature neonates.
Area of Science:
- Neonatal Medicine
- Pediatric Endocrinology
- Radiology
Context:
- Sick preterm infants often require radiographic imaging for diagnosis and management.
- Iodine-containing contrast agents are frequently used in such procedures.
- The impact of these agents on thyroid function in vulnerable preterm neonates requires careful evaluation.
Purpose:
- To prospectively assess iodine excretion and thyroid function (Thyroid Stimulating Hormone [TSH] and Thyroxine [T4]) in sick preterm infants following intravenous injection of an iodine-containing contrast agent (Conray).
- To compare iodine excretion patterns between preterm infants receiving contrast agents and those without central venous catheters.
- To determine the incidence of transient hypothyroxinemia and hypothyroidism in this population.
Summary:
- Twenty-two sick preterm infants received intravenous Conray, with TSH and T4 levels monitored post-injection.
- Urinary iodine excretion peaked on day one and declined by day three.
- Eighteen infants experienced transient hypothyroxinemia (T4 < 60 nmol/l), but no cases of hypothyroidism were confirmed.
- Iodine excretion in preterm infants with catheters was studied for comparison.
Impact:
- The study highlights a significant risk of transient hypothyroxinemia in sick preterm infants exposed to iodine-based contrast media.
- Findings suggest that the incidence of thyroid dysfunction may be lower than anticipated, but the risk is not negligible.
- The results support the recommendation to avoid or minimize the use of iodine-containing contrast agents for radiographic control in preterm infants whenever feasible.
Abstract:
22 sick preterm infants were enrolled in a prospective study of iodine excretion after intravenous injection of a definite amount of the radiopaque dye Conray. Measurements of TSH and T4 were performed on day 5 and 4 weeks after injection or before dismissal. For comparison iodine excretion was studied in a group of 10 pre-terms without central venous catheters. In most of the babies urinary excretion of iodine was highest on day one with an exponential decline to day three. Transient hypothyroxinemia (T4 less than 60 nmol/l) could be diagnosed in 18 infants, but no one had hypothyroidism in sick prematures after injection of iodine containing contrast agents seems to be lower than expected. Nevertheless this method of radiographic control should be avoided if possible.