Indocyanine green faecal excretion holds potential for diagnosis of neonatal biliary atresia

stitching suture

Aim of the study: This study aimed to establish an objective, simple, and minimally invasive screening method to detect patients with biliary atresia during neonatal checkups by using indocyanine green (ICG) fluorescence in the stool.

Material and methods: We produced a rat model of extrahepatic biliary obstruction (group O, n = 9) and compared the stools from these rats with those of control group rats (group C, n = 6) by a fluorescence technique. ICG was administered (0.5 mg/kg) through the caudal vein; group O received ICG at the end of surgery.

Results: In group C, we collected stools at 3, 6, 12, 24, 48, and 72 hours, and fluorescence disappeared at 48 hours. In group O, stools were collected at 24, 48, 72, 96, and 120 hours after surgery, and fluorescence continued at 120 hours without the loss of fluorescence. Quantitative assessment of lightness showed significant differences between the groups at 48 and 72 hours (p = 0.0016 and p = 0.0004, respectively).

Conclusions: This study shows that ICG is excreted into the gastrointestinal tract via a route other than the bile duct in a rat model of extrahepatic biliary obstruction. Our findings also suggest that ICG has the potential for initial screening of biliary congestive disease in the neonatal period, which could be followed up by detailed testing.

https://pubmed.ncbi.nlm.nih.gov/39845354

Clarifying Misconceptions About Iodine “Allergies” for Perioperative Patient Care

surgical instruments being shared

Iodine is a trace element that is required to produce thyroid hormone. Some preoperative skin antiseptics and contrast media that are used in a variety of specialties (eg, cardiovascular, urology) contain iodine. Clinicians and patients may believe that a history of a reaction to shellfish, povidone-iodine, or radiopaque contrast media is an allergy requiring avoidance of all three substances. Because iodine is required for life and does not stimulate an immune response, there is no relationship between iodine and adverse reactions to iodine-containing products. Perioperative nurses should have knowledge of allergies associated with iodine-containing substances and should assess patients for allergies.

During the assessment process, they can seek input on the cause of any previous reactions and share information on allergies with the patient. They also can collaborate with leaders and information technology personnel to update the electronic health record to avoid documentation of iodine as an allergen.

https://doi.org/10.1002/aorn.14267