1. A model for in situ plan of care for a critically unstable pediatric patient following I-131 MIBG infusion
- Author
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Annette M Scott, Gregory A. Yanik, Karl William Fischer, Waseem Ostwani, Rama Mwenesi, Heidi R. Flori, Justin Andrew Quinn, and Christina Marie Conrad
- Subjects
medicine.medical_specialty ,Resuscitation ,Michigan ,Critical Care ,Critical Illness ,MEDLINE ,Plan of care ,Iodine Radioisotopes ,03 medical and health sciences ,Neuroblastoma ,0302 clinical medicine ,Intensive care ,Patient-Centered Care ,Health care ,Medicine ,Dosimetry ,Humans ,Child ,Infusions, Intravenous ,Models, Statistical ,business.industry ,Radiotherapy Dosage ,Hematology ,Radiation Exposure ,Prognosis ,Clinical trial ,Pediatric patient ,3-Iodobenzylguanidine ,Oncology ,030220 oncology & carcinogenesis ,Pediatrics, Perinatology and Child Health ,Emergency medicine ,Female ,Radiopharmaceuticals ,business ,030215 immunology - Abstract
Recent clinical trials have moved iodine-131 (I-131) metaiodobenzylguanidine (MIBG) therapy into frontline management of high-risk neuroblastoma. With this expansion, it is reasonable to anticipate the need for intensive care level resuscitations. Radiation exposure remains the greatest risk to health care professionals managing these patients. We combined shock simulation scenario data with actual radiation dosimetry data to create a care model allowing for aggressive, prolonged in situ resuscitation of a critically ill pediatric patient after I-131 MIBG administration. This model will maintain a critical care provider's radiation level below 10% of the annual occupational dose limit (5 mSv, 500 mrem) per patient managed.
- Published
- 2020