Mitchell I M, Pollock J C, Jamieson M P, Fitzpatrick K C, Logan R W
Department of Cardiac Surgery, Royal Hospital for Sick Children, Yorkhill, Glasgow, Scotland.
Ann Thorac Surg. 1991 Nov;52(5):1138-40. doi: 10.1016/0003-4975(91)91295-7.
Povidone-iodine is an effective antiseptic, but its topical use has been associated with a number of adverse reactions in burn patients and in neonates as a result of transcutaneous absorption. In particular, high plasma iodine concentrations are known to cause renal failure, metabolic acidosis, and thyroid suppression. Because of the permeable nature of the skin in small infants and the large areas cleaned before cardiac operations, it is possible that significant transcutaneous iodine absorption might occur in this situation. We have studied 17 infants, less than 3 months of age, who were undergoing closed cardiac or thoracic procedures. After povidone-iodine skin preparation in 15 (covering 20% to 30% of body surface area), plasma total iodine concentrations rose fourfold (range, 160% to 1,440%). This increase was significantly different from the preoperative level at 6, 12, 18, and 24 hours. There was no increase in plasma iodine concentration in 2 patients who were not exposed to povidone-iodine or any other iodine-containing compound. We discuss the implications for a topical antisepsis policy in infants.
聚维酮碘是一种有效的防腐剂，但其局部应用因经皮吸收已在烧伤患者和新生儿中引发了一些不良反应。特别是，已知高血浆碘浓度会导致肾衰竭、代谢性酸中毒和甲状腺抑制。由于小婴儿皮肤的渗透性以及心脏手术前清洁的大面积皮肤，在这种情况下可能会发生大量经皮碘吸收。我们研究了17名年龄小于3个月、正在接受心脏或胸部闭合手术的婴儿。在15名婴儿（覆盖体表面积的20%至30%）进行聚维酮碘皮肤准备后，血浆总碘浓度增加了四倍（范围为160%至1440%）。在6、12、18和24小时时，这种增加与术前水平有显著差异。2名未接触聚维酮碘或任何其他含碘化合物的患者血浆碘浓度没有增加。我们讨论了婴儿局部抗菌政策的影响。
