Hunt J L, Sato R, Heck E L, Baxter C R
J Trauma. 1980 Feb;20(2):127-9. doi: 10.1097/00005373-198002000-00004.
Povidone-iodine ointment is a widely used topical antimicrobial agent in thermally injured patients. In 17 patients with burns ranging from 4 to 85% TBSA this agent was applied to both partial- and full-thickness burns. Peak serum iodine levels in patients treated within 24 hours of injury ranged from 595 to 4,900 micrograms per dL. The amount of iodine absorbed was directly related to the size of the burn. Serum iodine levels continued to rise until the drug was discontinued and remained elevated for as long as 7 days after discontinuance. Iodine excretion was directly related to renal function. The highest serum and lowest urinary iodine levels were present in patients who developed renal failure. Thyroid function was not affected by drug usage. A proven cause-and-effect relationship between the elevated serum iodine attributed to the absorption of povidone-iodine and metabolic acidosis, hypernatremia, and hyperosmolarity was not established. Close monitoring of the patient's fluid and electrolyte balance is imperative during drug usage. The drug is contraindicated in any patient with impaired renal function. The high serum levels of this inorganic ion imply potential toxicity, but clinical evidence of cell or organ toxicity is as yet undetermined.
聚维酮碘软膏是热损伤患者广泛使用的外用抗菌剂。在17例烧伤面积为4%至85%体表面积的患者中，该制剂应用于部分厚度和全层厚度烧伤。受伤后24小时内接受治疗的患者血清碘峰值水平为每分升595至4900微克。碘吸收量与烧伤面积直接相关。血清碘水平持续上升，直至停药，停药后长达7天仍保持升高。碘排泄与肾功能直接相关。发生肾衰竭的患者血清碘水平最高，尿碘水平最低。甲状腺功能不受药物使用影响。聚维酮碘吸收导致血清碘升高与代谢性酸中毒、高钠血症和高渗性之间尚未证实存在因果关系。用药期间必须密切监测患者的液体和电解质平衡。肾功能受损的任何患者禁用该药物。这种无机离子的高血清水平意味着潜在毒性，但细胞或器官毒性的临床证据尚未确定。
