Non-ionic contrast media: a comparison of iodine delivery rates during manual injection angiography

Abstract

Iodine delivery rates (IDR) of five commonly used non-ionic contrast media were determined at room temperature (24 degrees C) and body temperature (37 degrees C). Contrast media of strength 300 mgI/ml were also evaluated at 50% dilution (150 mgI/ml) with N-saline. Iodine delivery differed significantly (p less than 0.005) between samples at room temperature: Omnipaque 350 (1163 mg/s) less than Niopam 370 (1311 mg/s) less than Omnipaque 300 (1422 mg/s) less than Niopam 300 (1635 mg/s) and Ultravist 300 (1636 mg/s). Niopam 300 and Ultravist 300 delivered 41% more iodine per second than Omnipaque 350 at room temperature. Similar differences were identified at body temperature, while delivery of individual media was on average 23.5% greater than at room temperature. No significant difference between iodine delivery rates of diluted media at room temperature or body temperature was identified. The results demonstrate that iodine delivery and hence vascular opacification are better achieved during hand-injection arteriography by using relatively low viscosity media such as Niopam 300 or Ultravist 300. In digital subtraction arteriography all 300 strength contrast media diluted to 150 strength are equally effective.

Rate of Contrast Material Extravasations and Allergic-like Reactions: Effect of Extrinsic Warming of Low-Osmolality Iodinated CT Contrast Material to 37°C

“…Extrinsic warming of iodinated contrast material to 37°C reduces contrast material viscosity and has been advocated to decrease the frequency of adverse events related to intravenous administration (1)(2)(3)6,11,12 ) and to improve iodinated contrast material delivery ( 4,5 ). However, studies demonstrating effi cacy of a reduction in adverse risk from contrast material warming are scant, and the magnitude of demonstrable effect (when able to be shown at all [ 7 ]) has been small ( 6 ).…”

“…The study was designed to include two study periods: (a) 200 days immediately prior to the cessation of extrinsic iodinated contrast material warming (to 37°C) at our institution (period 1, from March 14, 2010, through September 30, 2010) and (b) 200 days immediately after the cessation of contrast material warming (period 2, from October 1, 2010, through April 19, 2011). The use of contrast material warmers was discontinued at our institution on October 1, 2010, for all E xtrinsic warming of roomtemperature iodinated contrast material to human body temperature (37°C) is known to reduce contrast ma terial viscosity ( 1-4 ), and results of some studies ( 4,5 ) have shown that the practice can improve contrast material delivery rates with both hand and power injections through intravenous catheters. However, to our knowledge, only one study ( 6 ) has shown that warming iodinated contrast material prior to intravenous administration actually confers a reduction in the risk of adverse events (12% vs 10% for highosmolality contrast material [HOCM]).…”

Accuracy of computed tomographic arthrography for assessment of articular cartilage defects in the ovine stifle

“…In the human knee and the ovine stifle, the meniscus, covering the tibial plateau and partially covering the femoral condyles, could prevent contrast to fully outline the cartilage. Passive mobilization of the joint and warming of the contrast medium (to enhance fluidity) are helpful to avoid this issue …”

Comparative rheology of low‐ and iso‐osmolarity contrast agents at different temperatures

“…Conversely, hand injections produced more variable flow; 3.5-6.0 ml/ sec in 6 F catheters, 1.8-3.0 ml/sec in 5 F catheters, and 1.4-2.0 ml/sec in 4 F catheters. Using forceful hand injections at 24 and 378C, Hughes and Bisset [23] studied iodine delivery rates through 5 F catheters with five different nonionic LOCM. Heating contrast agents produced a mean increase of 23% (range 20-27%) of delivery rate.…”