Intraoperative fluoroscopy allows real-time control of surgical procedures, permitting using minimally invasive techniques, with reduced anesthetic times. However, high exposure levels could be achieved, either in a single procedure or as a cumulative effect. So, special attention should be paid to intraoperative dosimetry, particularly in the very radiosensitive pediatric population (due to the high rate of cell division and life expectancy). Procedimental optimization and standardization of protective measures become essential. The discrepancy in the techniques used, the different regions and anatomical differentiations in pediatrics, lead...

A retrospective study was performed at Pediatric Hospital of Coimbra with DICOM headers in PACS data from 621 surgical interventions, including orthopaedic, central line placement, cochlear implant, pacemaker and urological surgeries. Fig.2 Two image intensifiers were used: Ziehm Vision Vario 3D® and Siemens Arcadis Varic®. Dose-area product was collected from each surgical procedure and paediatric patients were divided in age groups. Exposure values were then analysed with SPSS Statistics 17.0.

Our sample included 621 surgical interventions performed in children and adolescents from 0 to 18 years old, being 286 (54,3%) males and 241 (45,7%) females. 18 children were under 1 year old, 160 were 1-5, 110 were 6 e 10 years old, 194 were 11 to 15 and 139 were 16 to 18 years old (Fig 3). 290 of the analysed interventions were appendicular skeleton orthopaedic surgery, 158 were central line placement, 116 were axial skeleton orthopaedic surgery, 25 were cochlear implant, 11 were procedures...

Children are exposed to ionizing radiation (which has potential biologic effects) during intraoperative procedures guided with fluoroscopy. Due to their increased radiosensitivity, it is urgent to raise awareness to the importance of creating and implementing dose reduction strategies for these procedures. To do so, the first step would be to monitor the doses used in the paediatric institutions. The DAP values obtained at our hospital don’t exceed guidelines recommendations. However they’re heterogeneous between different age groups and procedures. It´s necessary to optimize and uniformize procedures,...

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