Study questions use of povidone-iodine

The commonly-used antiseptic combination, povidone-iodine, can have harmful effects on neonates, according to a new study. Elaine Siegfried, MD, of St. Louis University presented the findings at the annual meeting of the Society for Pediatric Dermatology in Sun Valley, ID, in September.

Povidone-iodine can be absorbed percutaneously and suppress thyroid function, which could cause serious long-term side effects, Siegfried found in a study that covered 27 neonatal units. All of the units commonly used the antiseptic combination when performing minor procedures on infants.

Siegfried told attendees at the meeting that several studies have linked iodine exposure to "dramatic, prolonged elevation" of iodine in the urine and plasma of neonates, "leading to conditions including transient hypothyroxinemia." While it is often considered benign, hypothyroxinemia in premature infants has been linked to a four- to 10-fold increased risk of cerebral palsy.

Chlorhexidine may be a better choice than povidone-iodine for use in neonatal units, Siegfriend says. She points out that it is both safer and more effective against gram-positive and gram-negative bacteria and yeast.

CE objectives

After reading this issue of Critical Care Management, participants in the continuing education program should be able to:

• discuss the significance of studies related to use of the pulmonary artery catheter;

• explain the importance of validating credentials in the practice of advancing pulmonary artery catheters;

• cite the key tenets of the Institute for Healthcare Improvement;

• describe the outcome of a study published in Critical Care Medicine on adverse drug events.