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Does the use of an iodine-containing contrast agent to visualise the PICC tip in preterm babies cause hypothyroidism? A randomised controlled trial
  1. Chandra Prakash Rath1,
  2. Mary Thomas2,
  3. Drew Sullivan3,
  4. Martin Kluckow2
  1. 1 Department of Neonatology, King Edward Memorial Hospital, Perth, Western Australia, Australia
  2. 2 Department of Neonatology, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia
  3. 3 Department of Radiology, Royal North Shore Hospital, Sydney, New South Wales, Australia
  1. Correspondence to Dr Chandra Prakash Rath, Department of Neonatology, King Edward Memorial Hospital, Perth, WA 6008, Australia; drcprath{at}


Aim To compare thyroid function tests in preterm neonates (<30 weeks and >48 hour old) exposed to iodine-based contrast with controls and ascertain the certainty of peripherally inserted central catheter (PICC) tip position.

Methods Infants requiring a PICC were randomised to receive 0.3 mL of iodine-containing contrast or normal saline. The primary outcome was the difference in thyroid-stimulating hormone (TSH) levels on day 14 post PICC insertion and on day 28 of life.

Results 41 infants were randomised with no significant differences in TSH level (mIU/L) at day 14 post PICC insertion (3.1 vs 2) or on day 28 of life (2.2 vs 1.7). The PICC tip was more easily localised in the contrast group (85% vs 55%). Urinary iodine levels were significantly increased in the contrast-exposed group.

Conclusion Use of contrast did not suppress subsequent thyroid function and helped visualise the PICC tip with more certainty.

Clinical trial registration number ACTRN12614000560695, pre-result.

  • preterm
  • iodine
  • thyroid function
  • percutaneous catheter

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  • Contributors CPR and MK presented idea, designed and developed the theory and performed the computations. CPR and MK verified the analytical methods. CPR, MK and MT conducted the study and analysed data. MK encouraged DS to investigate a specific aspect. All authors discussed the results and contributed to the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Parental/guardian consent obtained.

  • Ethics approval Northern Sydney local health district ethics committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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