Erythrocyte aggregation in iohexol and other nonionic media

Erythrocytes aggregate when blood comes into contact with solutions of nonionic substances such as glucose or the contrast medium iohexol, especially at a reduced pH (eg, 6.8). The aggregates are not clots because they form rapidly even in heparinized blood, do not contain fibrin, and disappear at once when they are added to plasma or other ionic media. Formation of these aggregates in solutions of glucose or iohexol can be decreased by including a low concentration of an ionic solute such as NaCl or by maintaining the pH close to 7.4.