Related Experiment Videos
[Changes in the blood and plasma volumes during diagnostic angiocardiography. Differences between high- and
R Schräder1, P Geigle, M Lemperle
1Abteilung für Kardiologie, Universität Frankfurt/Main.
Insights
High-osmolality contrast media significantly increase blood and plasma volumes during cardiac catheterization compared to low-osmolality media. This finding highlights the importance of contrast agent osmolality in cardiovascular procedures.
Area of Science:
- Cardiology
- Radiology
- Medical Imaging
Background:
- Diagnostic cardiac catheterization involves contrast media injection.
- Contrast media osmolality can influence physiological parameters.
- Understanding these effects is crucial for patient safety and procedure optimization.
Purpose of the Study:
- To compare the effects of high-osmolality amidotrizoic acid and low-osmolality iopamidol on blood and plasma volumes.
- To investigate the relationship between contrast medium dosage, osmolality, and volume changes.
- To quantify volume shifts during angiocardiography.
Main Methods:
- A randomized, double-blind study involving 30 patients with coronary heart disease or valvular defects.
- Measurement of blood and plasma volumes using the indocyanine-green method and hematocrit before and after contrast injection.
- Comparison between amidotrizoic acid (2.1 osmol/kg) and iopamidol (0.8 osmol/kg).
Main Results:
- Blood volume increased by 4.9% after amidotrizoic acid versus 0.4% after iopamidol (P < 0.05).
- Plasma volume increased by 11.8% after amidotrizoic acid versus 5.7% after iopamidol (P < 0.01).
- Plasma volume increase correlated with contrast medium dosage and osmolality.
Conclusions:
- High-osmolality contrast media cause a greater increase in blood and plasma volumes during angiocardiography.
- Volume changes are dependent on both the dose and osmolality of the contrast agent.
- These findings have implications for fluid management and patient monitoring during cardiac procedures.
Abstract:
Changes in blood and plasma volumes were investigated in the course of diagnostic cardiac catheterizations, comparing the effect of a high and a low osmolar contrast medium in 30 patients (5 women and 25 men; mean age 53 [19-76] years) with coronary heart disease (n = 27) or valvular defect (n = 3). Using a randomized, double-blind protocol 15 patients received amidotrizoic acid (2.1 osmol/kg; mean dosage 166 +/- 68 or 2.2 +/- 1.1 ml/kg), while 15 patients received iopamidol (0.8 osmol/kg; mean dosage 154 +/- 78 ml or 2.1 +/- 1.0 ml/kg). The indocyanine-green method and the haematocrit were used to measure blood and plasma volumes immediately before and after the angiocardiography. Blood volume after amidotrizoic acid injection increased by a mean of 4.9% (228 +/- 242 ml) and by 0.4% (17 +/- 197 ml) after iopamidol (P less than 0.05). Plasma volume increased by a mean of 11.8% (331 +/- 150 ml) after amidotrizoic acid and 5.7% (157 +/- 97 ml) after iopamidol (P less than 0.01). The increase in plasma volume correlated with the dose of contrast medium: 2 ml per ml amidotrizoic acid (r = 0.93) and 1 ml per ml iopamidol (r = 0.82).--During angiocardiography blood and plasma volume may increase by up to 500 ml, an increase which depends not only on dosage but also on the osmolality of the injected contrast medium.