The haemodynamic effects of iodinated water soluble radiographic contrast media: a review

Morcos, Sameh K.; Dawson, Peter; Jd, Pearson; Jeremy, JY; Davenport, Anthony P.; Yates, M S; Tirone, Piero; Cipolla, Piervitto; Haën, Christoph de; Muschick, Peter; Krause, W.; Refsum, Helge; Emery, Celia; Liss, Per; Nygren, Anders; Haylor, J.; Pugh, Neil D.; Karlsson, Jan

doi:10.1016/s0720-048x(98)00018-7

Cited by 60 publications

(54 citation statements)

References 142 publications

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“…Patients receiving calcium channel blockers may develop hypotension after left ventriculography with high osmolar ionic agents, since the latter can also induce peripheral vasodilatation and have a negative inotropic effect on the heart. These effects are not significant with modern low osmolar non-ionic contrast media, which are less vasoactive and have minimal negative inotropic effect on the myocardium [18][19][20].…”

Section: Contrast Media and Drugs Acting On The Central Nervous Systemmentioning

confidence: 92%

Contrast media: interactions with other drugs and clinical tests

2005

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Many patients with multiple medical problems who are receiving a variety of drugs are investigated with imaging techniques which require intravascular contrast media. The Contrast Media Safety Committee of the European Society of Urogenital Radiology therefore decided to review the literature and to draw up simple guidelines on interactions between contrast media and other drugs. An extensive literature search was carried out and summarized in a report. Based on the available information, simple guidelines have been drawn up. The report and guidelines were discussed at the 11th European Symposium on Urogenital Radiology in Santiago de Compostela. Contrast media may interact with other drugs, and may interfere with isotope studies and biochemical measurements. Awareness of the patient drug history is important to avoid potential hazards. Simple guidelines are presented.

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Section: Contrast Media and Drugs Acting On The Central Nervous Systemmentioning

confidence: 92%

Contrast media: interactions with other drugs and clinical tests

2005

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“…The pathophysiologic changes induced by CM and their deleterious effects on the kidney have been amply described [21]. CM injection causes a hypoperfusion state due to renal vasoconstriction to be followed by further renal parenchymal hypoxia, resulting in a 12–27% risk renal nephrotoxicity in patients with impaired renal function.…”

Section: Discussionmentioning

confidence: 99%

“…CM detrimental effects are caused by direct cytotoxicity of both ionics and nonionics and by hyperosmolarity (ionics) [9, 24]. Intravascular administration of CM can produce acute hemodynamic changes characterized by an increase in renal vascular resistance and a decrease in the glomerular filtration rate [21]. CM might as well induce pathophysiologic changes in the kidney, such as hypoxic tubular injury [20].…”

Section: Introductionmentioning

confidence: 99%

Effects of an Acute Dose of <i>L-</i>Arginine during Coronary Angiography in Patients with Chronic Renal Failure

Miller¹,

Dascalu²,

Rassin³

et al. 2003

Am J Nephrol

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Background: Contrast media (CM) are nephrotoxic and might further worsen renal function in patients with chronic renal failure. L-Arginine, the substrate of nitric oxide, protects kidney function and may improve endothelial function in patients with coronary artery disease. Hypothesis: Acute administration of L-arginine in a subset of patients with combined coronary artery disease and impaired kidney function during coronary angiography might prevent superimposed acute renal failure. Methods: A double-blind study of patients with mild/moderate chronic renal failure (Cr >1.7 mg/dl) undergoing coronary angiography (meglumine ioxaglate) was conducted. Patients received either L-arginine (300 mg/kg) or placebo and were followed for 48 h. Cardiac hemodynamic parameters, renal function and nitric oxide production were sequentially recorded. Results – Primary and Secondary: Both groups experienced a decrease of creatinine clearance 48 h following the procedure (p < 0.05). Creatinine levels slightly increased following the administration of L-arginine (p < 0.05) but not in the placebo treated group. No changes of systemic and cardiac pressures, total peripheral resistance or cardiac output were recorded within and between the treatment and placebo groups. Conclusion: CM injection causes an impairment of renal function. Addition of intravenous L-arginine during cardiac catheterizations in patients with chronic renal failure does not prevent CM-induced nephrotoxicity and does not affect endothelial dysfunction in the particular population studied by the authors, i.e. patients with coronary artery disease (CAD) of various degrees, or suspicion of CAD and chronic mild renal failure.

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“…As contrast agent is used intravenously during the performance of CTA, however, the possibility of some involvement in rebleeding cannot be ruled out. Contrast agent injection reportedly produces hemodynamic effects, resulting in a temporary rise in systemic blood pressure [23][24][25] and fluctuations in blood pressure during CTA may contribute to rebleeding. Management of fluctuations in blood pressure during the performance of CTA is therefore crucial.…”

Section: Case 5 (Figure 5)mentioning

confidence: 99%