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The Annals of Thoracic Surgery, Vol 39, 478-480, Copyright © 1985 by The Society of Thoracic Surgeons

ARTICLES

Iodine toxicity in a patient treated by continuous povidone-iodine mediastinal irrigation

PL Glick, BJ Guglielmo, RF Tranbaugh and K Turley

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.

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