Radiation exposure in neonatal intensive care unit of tertiary care hospital: a retrospective study
DOI:
https://doi.org/10.18203/2349-3291.ijcp20261530Keywords:
Neonatal intensive care unit, Preterm, Low birth weight, Radiation exposure, RadiographsAbstract
Background: This is retrospective observational study with aims to determine the mean number of radiographs exposure of neonates during their stay in the NICU and to identify risk factors for higher radiation exposure.
Methods: Total 1139 neonates were included in study. The following data were collected, birth weight, gestational age, risk factor, duration of stay, number and indication of radiograph and total radiation exposure. Radiograph was done by using Genuine TM portable X-ray machine. Each radiograph exposure accounts to 0.02 millisieverts (mSv) as per the manufacturer brochure. Statistical analysis was done by using SPSS var 23, ANOVA test, unpaired t-test was applied to test significance and p value of <0.05 was considered significant.
Results: Total 1139 neonates were enrolled of which 624 (54.8%) were male babies. Mean number of radiographs for entire sample was 2.76 (radiation exposure 0.05 mSv) with standard deviation (SD) of 2.97 (0.06mSv). Newborns < 28 weeks of gestation are more exposed to radiation with mean radiation of 0.1mSv±0.1mSv. Study observed that there is significant negative correlation of birth weight (r=-0.277) and gestational Age (r=-0.345) to radiation exposure. This indicates babies with prematurity and low birth weight are more exposed to radiation.
Conclusions: There is significant positive correlation between radiograph exposure and duration of stay (r=0.568) showing prolonged hospitalization causes more radiation exposure. Strategies to reduce radiation exposure, like using point-of-care ultrasound thus avoiding long term adverse effect. To know whether early radiation exposure may lead to adverse long-term consequences, follow-up study is necessary.
References
Khasawneh W, Sindiani A, Rawabdeh SA, Aleshawi A, Kanaan D. Indications and Clinical Profile of Neonatal Admissions: A Cross-Sectional Descriptive Analysis from a Single Academic Center in Jordan. J Multidiscip Healthc. 2020;13:997-1006.
Shah PS, Lui K, Sjörs G, Mirea L, Reichman B, Adams M, et al. Neonatal outcomes of very low birth weight and very preterm neonates: an international comparison. J pediatr. 2016;177:144-5.
Ono K, Akahane K, Aota T, Yoshizawa K, Kato H, Tanaka H. Neonatal doses from X-ray examinations by birth weight in a neonatal intensive care unit. Radiat Prot Dosim. 2003;103(2):155-62.
Donadieu J, Zeghnoun A, Roudier C, Hardouin JB, Deschamps F, Bréart G. Cumulative effective doses delivered by radiographs to preterm infants in a neonatal intensive care unit. Pediatrics. 2006;117(2):882-8.
Wrixon AD. New recommendations from the International Commission on Radiological Protection—a review. Phys Med Biol. 2008;53(8):R41-60.
Scott MV, Fujii AM, Behrman RH, Dillon JE. Diagnostic ionizing radiation exposure in premature patients. J Perinatol. 2014;34(5):392-5.
Kartikeswar GA, Parikh TB, Pandya D, Pandit A. Ionizing radiation exposure in NICU. Indian J Pediatr. 2020;87(2):158-60.
Puch-Kapst K, Juran R, Stöver B, Wauer RR. Radiation exposure in 212 very low and extremely low birth weight infants. Pediatrics. 2009;124(6):1556-64.
Pearce MS, Salotti JA, Little MP, McHugh K, Lee C, Kim KP, et al. Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. Lancet. 2012;380(9840):499-505.
Duffner PK. Long-term effects of radiation therapy on cognitive and endocrine function in children with leukemia and brain tumors. Neurologist. 2004;10(6):293-310.
Spycher BD, Lupatsch JE, Zwahlen M, Röösli M, Niggli F, Grotzer MA, et al. Background ionizing radiation and the risk of childhood cancer: a census-based nationwide cohort study. Environ Health Perspect. 2015;123(6):622-8.
Copetti R, Cattarossi L, Macagno F, Violino M, Furlan R. Lung ultrasound in respiratory distress syndrome: a useful tool for early diagnosis. Neonatology. 2008;94(1):52-9.
Durga D, Devi U, Gupta K, Maheshwari A, Suryawanshi P. Lung ultrasound as a novel tool to assess the severity and management of neonatal pneumonia. Newborn. 2023;2(4):291-6.