Koroner Anjiyografi Yapýlan Hastalarda Ýohexolün Solunum Fonksiyon Testi Parametrelerine Etkisi EFFECTS OF IOHEXOL ON PULMONARY FUNCTIONS IN PATIENTS UNDERGOING DIAGNOSTIC CORONARY ANGIOGRAPHY (original) (raw)
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Effects of iohexol on ventilatory functions in patients undergoing diagnostic coronary angiography
International Journal of Cardiovascular Imaging, 2004
Background and objectives Adverse respiratory reactions have been reported with intravascular radiographic contrast media. The aim of the present study is to assess the effects of iohexol on pulmonary functions in patients undergoing diagnostic coronary angiography (CA). Materials and methods: 30 patients enrolled in the study. The respiratory functions of the patients were measured at three different stages during angiography (before, immediately after and 2 h later) and arterial blood gas analyses were performed at six stages during CA (before, immediately after the insertion of angiography catheter, 2 min after the injection of contrast agent, at the end of angiography, an hour and 2 h after angiography). A single, experienced angiographer performed the angiography procedures via radial artery route. Totally six multiple angled views of the left and right coronary arteries were recorded in all patients by hand injection. None of the patients were performed ventriculography. Results: Angiography caused significant reduction in forced expiratory volume in 1 sec [FEV1] (from 103 ± 15 to 95 ± 17, p p p 1/FVC ratios at different stages of angiography. Statistically significant decrease in PaO2 (from 91 ± 10 to 85 ± 13 mmHg, p 2 saturation (from 97 ± 1% to 96 ± 1%, p Conclusions: Diagnostic CA using iohexol decreases ventilatory functions in a small but significant extent in patients without any overt pulmonary disease.
Cardiology Research and Practice, 2018
Purpose. e purposes of this study are to assess the acute effects of iodixanol, an iso-osmolar contrast media, on pulmonary functions and to evaluate the body composition in order to find out its role in causing this deterioration. Methods. 35 male and 25 female patients undergoing diagnostic coronary angiography (CA) were enrolled in the study. Before CA, all patients' body compositions were evaluated by measuring their body mass indexes (BMIs) and waist-to-hip ratios (WHRs). Total body waters (TBWs), fat masses (FMs), fat-free masses (FFMs), and basal metabolism rates (BMRs) were measured via bioimpedance analysis. e CA was performed via radial artery route using iodixanol in every patient. e pulmonary function tests of these patients were performed before, during, and 2 hours after the CA. FEV1∆, FEF 25-75% ∆, and FVC∆ parameters were calculated by subtracting the measured baseline value from the measurement after the CA. Results. Angiography caused significant reduction in forced
Addition of sodium to the nonionic contrast medium iohexol during coronary angiography in man
Acta Radiologica, 1992
It has recently been claimed that lack of sodium in nonionic contrast media may increase the risk of ventricular arrhythmias during coronary angiography. Thus. the influence of sodium addition to the nonionic contrast medium iohexol was studied in 75 patients with severe coronary heart disease. The study design was randomized, parallel and double-blind, and iohexol was given either with or without addition of NaCl (28 mmol/l). Both formulations induced a transient drop in arterial blood pressure, and prolongation of the QT interval and QRS duration at 10 s only (p<O.OI). The electrical QRS axis was significantly changed by the coronary artery injections after 10 s, but not later. No differences between iohexol with and without NaCl were observed for any of the variables studied. No serious arrhythmias were observed. Thus, the addition of NaCl (28 mmol/l) to iohexol did not influence the electrocardiographic or hemodynamic changes induced by iohexol during coronary angiography.
British Journal of Radiology, 1993
The recent need for selective bronchography during bronchoscopy in certain patients, together with paediatric indications for tracheo-bronchography, raises the question as to which contrast medium is both safe and efficient. The purpose of the present experimental study was to define the tissue reaction caused by iotrolan and iopamidol in the bronchi and lungs of rats. 60 animals used in this study were divided into five groups receiving iotrolan 300, iopamidol 370, iopamidol 150, physiological saline and anaesthetic only, the last two acting as control groups. Statistically there was no significant difference in the histological reaction between iotrolan 300, iopamidol 370 and iopamidol 150 compared with the control groups, although iotrolan 300 appeared to result in the least tissue reaction. With its adequately high iodine concentration, low osmolality and relatively high viscosity, iotrolan 300 would appear to be a suitable contrast medium for bronchography.
European Journal of Radiology, 1992
The low osmolar, non-ionic X-ray contrast media have shown a lower frequency of adverse events than the older ionic ones. In this study changes in routine clinical-chemical parameters in blood and urine, vital signs and adverse events were recorded in six groups of 10 healthy male volunteers receiving either iodixanol, a new non-ionic, dimeric X-ray contrast medium for general vascular use, or one of the two non-ionic, monomeric contrast media iopentol and iopamidol. Minor decreases were observed in the values for haemoglobin, haematocrit and erythrocytes 5 min and 3 days after injection of iodixanol. A minor increase was seen in platelets and total protein after 3 days. A transient increase in serum osmolality was seen 5 min after the injections of iopentol and iopamidol. This was not seen in any iodixanol group. The level of thyrotropin showed an increase in all groups at 3 days. It was back to normal within 21 days. No changes of clinical importance were seen regarding blood pressure, heart rate or ECG in any volunteer. No severe adverse events were reported. All events were of short duration, and of mild or moderate intensity. The results, however, may indicate a lower frequency of adverse events/discomfort after the administration of the dimeric iodixanol than the 2 monomeric contrast media iopentol and iopamidol.
Review article: Effects of radiographic contrast media on the lung
British Journal of Radiology
The pulmonary adverse effects of intravascular use of water soluble radiographic contrast media (RCM) include bronchospasm, pulmonary oedema and increase in the pulmonary arterial blood pressure (Ppa). Symptomatic bronchospasm is rare but subclinical increase in airways resistance is common after intravascular injection of RCM. Experimental studies have demonstrated that the low osmolar ionic dimer ioxaglate can induce significant bronchospasm in comparison with other types of RCM. Histamine and endothelin, which are potent bronchoconstrictors and released in response to the administration of RCM, do not seem to mediate the bronchospastic effect of RCM. Pretreatment with corticosteroids or antihistamine does not appear to prevent RCM induced bronchospasm, but the administration of b 2 adrenergic agonist can abolish this adverse effect. RCM induced pulmonary oedema can be secondary to endothelial injury causing an increase in the permeability of the microcirculation. It may also occur in patients with incipient cardiac failure, when large doses of RCM particularly of the high osmolar type are used. A rise in Ppa induced by RCM seems to be secondary to an increase in pulmonary vascular resistance through direct effects on the pulmonary circulation. Low osmolar non ionic monomers induce the least changes in the pulmonary circulation and should be the contrast media of choice for intravascular use in patients with pulmonary hypertension. The mechanisms responsible for the effects of RCM on airway resistance and pulmonary circulation remain unclear. Intrabronchial administration of high osmolar water soluble RCM is dangerous and can induce severe bronchial irritation and pulmonary oedema. Low osmolar RCM are well tolerated by the lungs following aspiration with minimal histological reaction.
The High Incidence of Pulmonary Functional Abnormalities in Patients with Coronary Artery Disease
Chest, 1974
Ventilatory function was studied in 51 snbjects undergoing coronary arteriography because of known or sue peeted coronary artery disease. An subjects were free of systemic hypertension or other forms of heart disease and none was in congestive heart failure. !My percent of those with objective evidence of coronary artery disease and/or left ventricular dysfnnction had at least one abnonbatity of ventilatory fnnctioa. Pulmonary functional abnormalities were nd clearly rewed to the number of objective abnormalities, bnt the nnmber of snbjects was small. There was no relationship between the severity of
European Journal of Radiology, 1998
Objecti6e: A double-blind randomised study was conducted in two British centres, to evaluate the safety, tolerance and efficacy of the new dimeric non-ionic contrast medium Iotrolan 320 in comparison with the monomeric non-ionic compound Iohexol 350 in coronary angiography. Methods and Material: 120 patients were randomised to receive either Iotrolan at a concentration of 320 mgI/ml or Iohexol at a concentration of 350 mgI/ml, during selective coronary angiography and left ventriculography. The variables measured were: maximum increase of the left ventricular end-diastolic pressure up to 6 min after ventriculography, haemodynamic and electrocardiographic variables, arrhythmogenicity, clinical laboratory parameters, tolerance, adverse events and efficacy. Results: Iotrolan resulted in a smaller change of left ventricular end-diastolic pressure compared to Iohexol, but the difference was not statistically significant. Transient changes in left ventricular systolic pressure, intra-arterial systolic pressure, intra-arterial diastolic pressure, and in electrocardiographic parameters, occurred after the injections, but they were not clinically significant. Changes in the clinical laboratory markers from baseline values were comparable between the two groups and confirmed good renal and hepatic tolerance. During the left ventriculogram, Iotrolan resulted in less symptoms compared to Iohexol (P=0.002). Adverse events, which were mild or moderate in most cases, were observed with no statistical difference between the two agents. The contrast quality of both agents was good with no statistical difference. Conclusion: This study did not show a significant difference between Iotrolan 320 and Iohexol 350 with regard to cardiovascular safety or patient tolerance, except for a minor difference in the intensity of heat/warmth sensation.