Ghent University Academic Bibliography

Advanced

How to remove accumulated iodine in burn-injured patients

Sunny Eloot UGent, Annemieke Dhondt UGent, Eric Hoste UGent, Alain Verstraete UGent, Jan De Waele UGent, Kirsten Colpaert UGent, Henk Hoeksema, FIONA TROMP UGent and Raymond Vanholder UGent (2010) NEPHROLOGY DIALYSIS TRANSPLANTATION. 25(5). p.1614-1620
abstract
Background. Absorption of large quantities of iodine, as induced by the use of topical antimicrobial povidone–iodine in burn-injured patients, may cause metabolic and electrolyte abnormalities as well as renal failure. To diminish iodine levels, haemodialysis was previously reported to be a suitable therapy. We therefore studied the kinetics of iodine in order to define the most optimal dialysis strategy. Methods. Two patients with elevated iodine levels (93.6 and 81.2 mg/L) underwent continuous dialysis with blood flows QB 150 and 120 mL/min. Blood was sampled from the inlet and outlet dialysis line at several time points during a 7-h and 39-h 10-min period, respectively. Samples were analysed for iodine with the inductively coupled plasma mass spectrometry (ICPMS) method. Kinetic analysis was performed using one and two compartmental models, deriving kinetic parameters: plasmatic volume V1, extraplasmatic volume V2 and intercompartmental clearance K12. The calibrated kinetic model of Patient 2 was further used to simulate different dialysis strategies: 12-h per day with QB 240, 6-h per day with QB 480 and 240, and 12-h every 2 days with QB 240. For each strategy, the mean average plasmatic and extraplasmatic concentration (TACp and TACep) was calculated during 48 h. Results. Iodine seemed to follow one compartmental kinetics when serum sample collections were limited to the first 7 h of dialysis (Patient 1), but iodine appeared to be distributed in two volumes (V1=19.4 L, V2=38.0 L and K12=55 mL/min) when a longer observation period was taken into account (Patient 2). The simulations disclosed that 12-h dialysis per day with QB 240 or continuous dialysis with QB 120 resulted in the lowest TACp (18.2 and 19.0 µg/L) and TACep (34.4 and 36.1 µg/L). Conclusion. In patients with elevated iodine levels, especially when associated with renal failure, haemodialysis with a minimum 12-h duration with sufficient blood flow should be the first choice to remove iodine.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
burn injury, compartmental behaviour, dialysis strategy, POVIDONE-IODINE, ACUTE-RENAL-FAILURE, iodine, kinetic modelling, MEDIASTINAL IRRIGATION, HEMODIALYSIS DURATION, GUANIDINO COMPOUNDS, IMPACT, ABSORPTION, TEMPERATURE, KINETICS, INDUCTION
journal title
NEPHROLOGY DIALYSIS TRANSPLANTATION
Nephrol. Dial. Transplant.
volume
25
issue
5
pages
1614 - 1620
Web of Science type
Article
Web of Science id
000276994400044
JCR category
UROLOGY & NEPHROLOGY
JCR impact factor
3.564 (2010)
JCR rank
12/68 (2010)
JCR quartile
1 (2010)
ISSN
0931-0509
DOI
10.1093/ndt/gfp647
language
English
UGent publication?
yes
classification
A1
copyright statement
I have retained and own the full copyright for this publication
id
833437
handle
http://hdl.handle.net/1854/LU-833437
date created
2010-01-22 09:12:14
date last changed
2010-11-03 14:04:09
@article{833437,
  abstract     = {Background. Absorption of large quantities of iodine, as induced by the use of topical antimicrobial povidone--iodine in burn-injured patients, may cause metabolic and electrolyte abnormalities as well as renal failure. To diminish iodine levels, haemodialysis was previously reported to be a suitable therapy. We therefore studied the kinetics of iodine in order to define the most optimal dialysis strategy.
Methods. Two patients with elevated iodine levels (93.6 and 81.2 mg/L) underwent continuous dialysis with blood flows QB 150 and 120 mL/min. Blood was sampled from the inlet and outlet dialysis line at several time points during a 7-h and 39-h 10-min period, respectively. Samples were analysed for iodine with the inductively coupled plasma mass spectrometry (ICPMS) method. Kinetic analysis was performed using one and two compartmental models, deriving kinetic parameters: plasmatic volume V1, extraplasmatic volume V2 and intercompartmental clearance K12. The calibrated kinetic model of Patient 2 was further used to simulate different dialysis strategies: 12-h per day with QB 240, 6-h per day with QB 480 and 240, and 12-h every 2 days with QB 240. For each strategy, the mean average plasmatic and extraplasmatic concentration (TACp and TACep) was calculated during 48 h.
Results. Iodine seemed to follow one compartmental kinetics when serum sample collections were limited to the first 7 h of dialysis (Patient 1), but iodine appeared to be distributed in two volumes (V1=19.4 L, V2=38.0 L and K12=55 mL/min) when a longer observation period was taken into account (Patient 2). The simulations disclosed that 12-h dialysis per day with QB 240 or continuous dialysis with QB 120 resulted in the lowest TACp (18.2 and 19.0 {\textmu}g/L) and TACep (34.4 and 36.1 {\textmu}g/L).
Conclusion. In patients with elevated iodine levels, especially when associated with renal failure, haemodialysis with a minimum 12-h duration with sufficient blood flow should be the first choice to remove iodine.},
  author       = {Eloot, Sunny and Dhondt, Annemieke and Hoste, Eric and Verstraete, Alain and De Waele, Jan and Colpaert, Kirsten and Hoeksema, Henk and TROMP, FIONA and Vanholder, Raymond},
  issn         = {0931-0509},
  journal      = {NEPHROLOGY DIALYSIS TRANSPLANTATION},
  keyword      = {burn injury,compartmental behaviour,dialysis strategy,POVIDONE-IODINE,ACUTE-RENAL-FAILURE,iodine,kinetic modelling,MEDIASTINAL IRRIGATION,HEMODIALYSIS DURATION,GUANIDINO COMPOUNDS,IMPACT,ABSORPTION,TEMPERATURE,KINETICS,INDUCTION},
  language     = {eng},
  number       = {5},
  pages        = {1614--1620},
  title        = {How to remove accumulated iodine in burn-injured patients},
  url          = {http://dx.doi.org/10.1093/ndt/gfp647},
  volume       = {25},
  year         = {2010},
}

Chicago
Eloot, Sunny, Annemieke Dhondt, Eric Hoste, Alain Verstraete, Jan De Waele, KIRSTEN COLPAERT, Henk Hoeksema, FIONA TROMP, and Raymond Vanholder. 2010. “How to Remove Accumulated Iodine in Burn-injured Patients.” Nephrology Dialysis Transplantation 25 (5): 1614–1620.
APA
Eloot, Sunny, Dhondt, A., Hoste, E., Verstraete, A., De Waele, J., COLPAERT, K., Hoeksema, H., et al. (2010). How to remove accumulated iodine in burn-injured patients. NEPHROLOGY DIALYSIS TRANSPLANTATION, 25(5), 1614–1620.
Vancouver
1.
Eloot S, Dhondt A, Hoste E, Verstraete A, De Waele J, COLPAERT K, et al. How to remove accumulated iodine in burn-injured patients. NEPHROLOGY DIALYSIS TRANSPLANTATION. 2010;25(5):1614–20.
MLA
Eloot, Sunny, Annemieke Dhondt, Eric Hoste, et al. “How to Remove Accumulated Iodine in Burn-injured Patients.” NEPHROLOGY DIALYSIS TRANSPLANTATION 25.5 (2010): 1614–1620. Print.