AAP PaperRadiation exposure and safety practices during pediatric central line placement☆
Section snippets
Methods
Approval was obtained from the local institutional review board for this retrospective study (study number 042013-063). All fluoroscopically guided central venous access procedures performed on pediatric patients by 11 surgeons at a single institution over the calendar year 2012 were analyzed through query of the electronic medical record system. All surgeons had completed a formal pediatric surgery fellowship and had been staff physicians for longer than 1 year at the time of the study.
Results
386 CVL procedures were reviewed on 325 patients of whom 46 had repeat procedures. Patient ages ranged from newborn to 22 years. The median patient age was 4 years (8 months, 11 years [IQR]). Of these cases, 18% had incomplete Ka,r exposure data; however, all FT data were collected. FT per procedure ranged from less than 1 second to 8.1 minutes with a median of 12.8 seconds (5.5, 29.5 seconds [IQR]). The range of entrance exposure per procedure was 12 μGy to 37.9 mGy with a median of 0.72 mGy (0.32, 2.12
Discussion
Our investigation examined the ionizing radiation exposure to patients and surgeons as well as radiation safety practices during pediatric fluoroscopic CVL placement. We found that the majority of CVL procedures reviewed had low patient exposure with an FT of less than 15 seconds, entrance exposures less than 1 mGy, and a median patient effective dose of 0.13 mSv. One mGy is the equivalent of 10 chest x-rays in an adult or 17 in a newborn [6]. There was one case that extended beyond 8 minutes of FT
Acknowledgements
We appreciate the support of Dr. Steven E. Wolf, Mary A. Wallace, and Rachel Renkes.
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Research reported in this publication was supported by the National Institute for General Sciences of the National Institutes of Health under award number T32GM008593.