Iodine toxicity in a patient treated by continuous povidone-iodine mediastinal irrigation.
Continuous povidone-iodine irrigation is frequently used to treat mediastinitis after median sternotomy and has been considered safe and effective. We describe a 34-month-old patient with mediastinitis after median sternotomy who was treated with continuous povidone-iodine irrigation and who absorbed toxic quantities of iodine (total serum iodine, 9,375 micrograms/dl; normal range, 4.5 to 9.0 micrograms/dl). An unexplained metabolic acidosis developed, along with changes in mental status, and the patient died. This experience and a thorough review of the literature lead us to believe that continuous povidone-iodine irrigation of the mediastinum is contraindicated.
D000138:Acidosis / Q000139:chemically induced; D002675:Child, Preschool; D006801:Humans; D007455:Iodine / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008480:Mediastinitis / Q000209:etiology / Q000628:therapy*; D011183:Postoperative Complications; D011205:Povidone / Q000627:therapeutic use; D013771:Tetralogy of Fallot / Q000601:surgery; D007507:Therapeutic Irrigation
D007455:Iodine; D011205:Povidone