Radiation Exposure in the Neonatal Intensive Care Unit in Newborns and Staff

Abstract

Objective Portable X-rays remain one of the most frequently used diagnostic procedures in neonatal intensive care units (NICU). Premature infants are more sensitive to radiation-induced harmful effects. Dangers from diagnostic radiation can occur with stochastic effects. We aimed to determine the radiation exposure in premature infants and staff and determine the scattering during X-ray examinations in the NICU. Study Design In this prospective study, dosimeters were placed on premature infants who were ≤1,250 g at birth and ≤30 weeks of gestational age who stayed in the NICU for at least 4 weeks. The doses were measured at each X-ray examination during their stay. The measurements of the nurses and the doctors in the NICU were also performed with dosimeters over the 1-month period. Other dosimeters were placed in certain areas outside the incubator and the results were obtained after 1 month. Results The mean radiation exposure of the 10 premature infants, monitored with dosimeters, was 3.65 ± 2.44 mGy. The mean skin dose of the six staff was 0.087 ± 0.0998 mSV. The mean scattered dose was 67.9 ± 26.5 µGy. Conclusion Relatively high exposures were observed in 90% of the patients and two staff. The radiation exposure levels of premature infants and staff may need to be monitored continuously. Key Points

Ultrasonography for Determining Endotracheal Tube Tip Position in Very Low Birth Weight Infants

“…Besides, compared with the previous studies, our patient group has very low gestational age and birth weight medians, reflecting the patient population with the highest mechanical ventilation need and possible radiation exposure. 3,13 Our study shares some significant results with the valuable studies mentioned above. However, we think that; this is the first study to collect these prominent features in one study, such as; the application of USG by neonatologists, high visualization rate, and optimum patient number, and most importantly, very low gestational age and birth weight values; in one study.…”

“…In NICUs not using bedside digital radiography, using USG will give a chance to correct the tip position to the neonatologists in one session and save much precious time. Besides, compared with the previous studies, our patient group has very low gestational age and birth weight medians, reflecting the patient population with the highest mechanical ventilation need and possible radiation exposure 3,13 …”

“…Although studies reported lower doses than the "annual exposure limit," the less radiation exposure, the better, considering the stochastic effect of radiation. 13 For all these reasons, there are increasing studies on determining the ETT tip location with USG, which is used in many different subjects in neonatology clinics. 1 The role and feasibility of USG use in neonatology practice have been evaluated by Saul et al from different perspectives.…”

“…Finally, an overlooked point about radiation exposure is that it may affect the concerned patient and as well as the surrounding patients and staff. Although studies reported lower doses than the “annual exposure limit,” the less radiation exposure, the better, considering the stochastic effect of radiation 13 . For all these reasons, there are increasing studies on determining the ETT tip location with USG, which is used in many different subjects in neonatology clinics 1 …”