Aiba M, Ninomiya J, Furuya K, Arai H, Ishikawa H, Asaumi S, Takagi A, Ohwada S, Morishita Y
Department of Surgery, Fujiyoshida City Hospital, Yamanashi, Japan.
Surg Today. 1999;29(2):157-9. doi: 10.1007/BF02482241.
A critical elevation of povidone-iodine absorption which occurred in a burn patient who was topically treated with 10% povidone-iodine (PI) gel is herein reported. A 65-year-old man was admitted to our hospital for deep second- and third-degree burns covering 26% of his total body surface area. The intravenous administration with lactated Ringer's solution and topical treatment with silver sulfadiazine were applied in addition to such treatments as debridement and skin grafting. However, wound infection occurred due to Pseudomonas aeruginosa. Topical treatment with PI gel was effective for this condition. Persistent nodal bradycardia with hypotension, metabolic acidosis, and renal failure occurred 16 days after the start of PI gel treatment. Iodine toxicosis caused by PI gel was suspected with a serum iodine level of 20600 microg/dl (normal range 2-9 microg/dl). The PI gel treatment was therefore discontinued immediately, and hemodialysis was scheduled. However, the patient's family refused hemodialysis and he died 44 days after admission. To our knowledge, only eight patients with iodine toxicosis have been reported in burn patients treated with PI gel.
本文报告了一名烧伤患者在接受10%聚维酮碘（PI）凝胶局部治疗时发生的聚维酮碘吸收临界升高情况。一名65岁男性因深二度和三度烧伤入院，烧伤面积占其全身表面积的26%。除了清创和皮肤移植等治疗外，还进行了乳酸林格氏液静脉输注和磺胺嘧啶银局部治疗。然而，患者因铜绿假单胞菌发生伤口感染。PI凝胶局部治疗对该病情有效。在开始PI凝胶治疗16天后，患者出现持续性结性心动过缓伴低血压、代谢性酸中毒和肾衰竭。怀疑PI凝胶导致碘中毒，血清碘水平为20600微克/分升（正常范围为2 - 9微克/分升）。因此立即停止PI凝胶治疗，并安排进行血液透析。然而，患者家属拒绝血液透析，患者在入院44天后死亡。据我们所知，在用PI凝胶治疗的烧伤患者中，仅报告了8例碘中毒患者。
