Published online March 1, 2006
PEDIATRICS Vol. 117 No. 3 March 2006, pp. 882-888 (doi:10.1542/peds.2005-0817)

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SPECIAL ARTICLE

Cumulative Effective Doses Delivered by Radiographs to Preterm Infants in a Neonatal Intensive Care Unit

Jean Donadieu, MD, PhD^a, Abdelkrim Zeghnoun, PhD^a, Candice Roudier, MSc^a, Carlo Maccia, PhD^b, Phillipe Pirard, MD^a, Christine André, MD^c,d, Catherine Adamsbaum, MD^c,d, Gabriel Kalifa, MD^c,d, Paul Legmann, MD^c,e, Pierre-Henri Jarreau, MD, PhD^c,,f

^a Département Santé et Environnement, Institut de Veille Sanitaire, St Maurice, France
^b Centre d'Assurance de Qualité ds Applications Technologiques dans le Domaine de la Santé (CAATS), Bourg la Reine, France
^c Université Paris-Descartes, Faculté de Médecine, Assistance Publique-Hôpitaux de Paris, Paris, France
^d Service de Radiologie Pédiatrique, Hôpital Saint-Vincent-de-Paul, Université Paris-Descartes, Paris, France
^e Service de Radiologie A, Hôpital Cochin, Paris, France
^f Service de Médecine Néonatale de Port-Royal, Hôpital Cochin, Paris, France

OBJECTIVE. We sought to determine the number and distribution of radiographs and the cumulative effective radiograph doses (cED) received by a population of preterm infants (PIs) hospitalized in an NICU.

STUDY DESIGN. We reviewed the files of all preterm infants (gestational age: <34 weeks) who were admitted to an NICU during an 18-month period and were discharged alive. A generalized additive model was used to study the relationship between cED and patient characteristics.

RESULTS. Four hundred fifty files were analyzed. The median gestational age was 30.1 weeks (range: 24.1–33.9 weeks), and the median birth weight was 1250 g (range: 520–2760 g). The median number of radiographs per infant was 10.6 (range: 0–95), and the median cED was 138 µSv (range: 0–1450 µSv). The cumulative dose exceeded 500 µSv in 7.6% of the cases. Factors that influenced the cumulative effective dose were gestational age, birth weight, care procedures, and clinical adverse events.

CONCLUSIONS. Given the potentially life-threatening complications of PIs, cumulative radiograph doses received in the ICU seem low with regard to environmental exposure and international recommendations. Additional studies are needed to evaluate the possible lifetime consequences of exposure to ionizing radiation at this age.

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Key Words: ionizing radiation • preterm infants • exposure • intensive care

Abbreviations: ED—effective dose • cED—cumulative effective dose • RDS—respiratory distress syndrome • BPD—bronchopulmonary dysplasia • CPAP—continuous positive airway pressure • CT—computed tomography • CI—confidence interval

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Accepted Jul 25, 2005.

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