Ionising radiation from diagnostic x rays in very low birthweight babies

Sutton, Paul M.; Arthur, Rosemary; Taylor, Clare; Stringer, M. D.

doi:10.1136/fn.78.3.f227

Cited by 37 publications

(31 citation statements)

References 2 publications

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“…18 Similar distributions of conventional radiographs have been reported for preterm infants and neonates, 19,20 for VLBW infants, 9 and for ELBW infants. 10 We found that 4% of infants required Ͼ30 radiographs, lower than the 7% previously reported.…”

Section: Discussionsupporting

confidence: 77%

Radiation Exposure in 212 Very Low and Extremely Low Birth Weight Infants

et al. 2009

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Section: Discussionsupporting

confidence: 77%

Radiation Exposure in 212 Very Low and Extremely Low Birth Weight Infants

et al. 2009

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“…The fetuses of her time are our preterm infants of modern Neonatology today. Despite the low risks associated with each radiograph, Sutton et al 4 concluded that overall radiation doses in the NICUs may have been underestimated in earlier studies for several reasons. First, infants may be referred to other hospitals, where additional examinations may be ordered.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] During their prolonged and complicated medical course in the Neonatal Intensive Care Units (NICUs), these neonates are exposed to repeated diagnostic procedures that involve X-ray radiation. [4][5][6] Owing to the high frequency of respiratory disease and other morbidities, these infants continue to require additional X-ray evaluations through early childhood and over time could receive substantial accumulating doses of radiation. 4 Gonadal exposure to ionizing radiation of the neonate, particularly preterm infants, is another important issue since irradiation before adulthood may have long-term harmful effects on the size and function of the gonads.…”

Section: Introductionmentioning

confidence: 99%

“…[4][5][6] Owing to the high frequency of respiratory disease and other morbidities, these infants continue to require additional X-ray evaluations through early childhood and over time could receive substantial accumulating doses of radiation. 4 Gonadal exposure to ionizing radiation of the neonate, particularly preterm infants, is another important issue since irradiation before adulthood may have long-term harmful effects on the size and function of the gonads. [7][8][9] Detailed studies on the field size and body tissues included in each X-ray taken on these infants are scarce.…”

Section: Introductionmentioning

confidence: 99%

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Unintentional exposure of neonates to conventional radiography in the Neonatal Intensive Care Units

et al. 2007

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Objective: To evaluate the extent of unintentional exposure to X-rays performed during routine diagnostic procedures in the Neonatal Intensive Care Units (NICUs).Study Design: During a 1-month period, 157 consecutive neonates from five level-III NICUs were recruited for this study. The mean birth weight was 1747±911 g (range: 564-4080 g), and gestational age was 31.6±3.6 weeks (range: 24-41 weeks). A total of 500 radiographs were performed including chest (68%), abdomen (17%) and combined chest and abdomen (15%). The average number of radiographs taken per infant was 4.2±3.6 (range: 1-21). Unintentional inclusion of body regions other than those ordered was determined by comparing the areas that should be included in the radiation field according to International recommendations, to those that appeared in the actual radiograph.Result: A comparison of the recommended borders to the actual boundaries of the radiographs taken show an additional exposure to radiation in all three procedures: 85% of chest radiographs also included the whole abdomen, 64% of abdomen radiographs included both thigh and upper chest and 62% of chest and abdomen radiograph included the thigh. (The range in all procedures was from ankle to upper head.) Between 2 and 20% of the relevant targeted body tissues were not included in the exposed fields resulting in missing data. The gonads of both sexes were exposed in 7% in all chest X-rays. Among male infants, the testes were exposed in 31% of plain abdomen radiographs and 34% of chest and abdomen radiographs. Conclusion:In the NICUs participating in the study, neonates are currently being exposed to X-ray radiation in nonrelevant body regions.Higher awareness and training of the medical teams and radiographers are required to minimize unnecessary exposure of newborns to ionizing radiation.

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“…Studies have found that neonates are exposed to an average of 9 to 31 X-rays during their hospitalization to the NICU. [19][20][21][22] The physical positioning of the infant required for different views can introduce instability for the infant and may displace the catheter(s). In our study, four patients in the ultrasound group required more than the requisite two X-rays.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided umbilical catheter insertion in neonates

Fleming

Kim

2011

J Perinatol

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Objective: Umbilical catheter placement is a routine neonatal emergency procedure that has large variability in technical methods. Commonly used methods are unable to accurately estimate insertion lengths, and X-rays cannot always identify malpositioned catheters. In clinical practice, the placement of umbilical lines takes time away from nursing during a critical transition period. Ultrasound is a safe and commonly used tool in the nursery for clinical management of sick neonates and has been shown to readily identify central catheter tip position. In this study, we sought to determine a more time-efficient and accurate means of umbilical catheter placement using bedside ultrasound.Study Design: This is a prospective, randomized, pilot trial of infants of any age or weight admitted to the neonatal intensive care unit who required umbilical catheter placement. Infants were excluded if they had congenital heart disease, abdominal wall defects or had a single umbilical artery. Catheters were placed using either the conventional method, with blinded evaluation of the catheters using ultrasound, or with ultrasound guidance, with input pertaining to catheter tip location. The number of X-rays required to confirm proper positioning, completion time points throughout the procedure and manipulations of the lines were recorded for both groups.Result: Ultrasound use decreased the time of line placement with an average saving of 64 min, as well as decreased the number of manipulations required and X-rays taken to place the catheters. The average X-ray time from request to viewing per X-ray was 40 min for all subjects.Conclusion: Ultrasound-guided umbilical catheter placement is a faster method to place catheters requiring fewer manipulations and X-rays when compared with conventional catheter placement.

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Ionising radiation from diagnostic x rays in very low birthweight babies

Cited by 37 publications

References 2 publications

Radiation Exposure in 212 Very Low and Extremely Low Birth Weight Infants

Radiation Exposure in 212 Very Low and Extremely Low Birth Weight Infants

Unintentional exposure of neonates to conventional radiography in the Neonatal Intensive Care Units

Ultrasound-guided umbilical catheter insertion in neonates

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