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[Blood cell count, sodium, potassium, calcium, osmolality and viscosity during pediatric angiocardiography with
M R Moura1, F Leboute, C A Gottschall
1Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia.
Insights
Pediatric blood changes during angiocardiography are partly due to ioxaglate contrast media (CM), but other factors like procedure duration and glucose infusion also play a role. Further research is needed to fully understand these complex hematological shifts.
Area of Science:
- Pediatric Cardiology
- Radiology
- Hematology
Context:
- Angiocardiography is a crucial diagnostic procedure in pediatric cardiology.
- Contrast media (CM) used in these procedures can potentially affect blood parameters.
- Understanding these effects is vital for patient safety and accurate interpretation of results.
Purpose:
- To investigate the specific blood parameter changes in pediatric patients undergoing angiocardiography.
- To differentiate the effects of ioxaglate contrast media from other procedural factors.
- To identify independent variables contributing to observed hematological alterations.
Summary:
- This study analyzed blood samples from 35 pediatric patients before, during, and after angiocardiography with ioxaglate.
- Significant changes were observed in hematocrit, hemoglobin, white blood cell count, sodium, potassium, calcium, and viscosity.
- Ioxaglate was partially linked to changes in hematocrit, hemoglobin, calcium, and viscosity, while procedure duration and glucose infusion influenced other parameters.
Impact:
- Highlights that contrast media are not the sole cause of blood changes during pediatric angiocardiography.
- Identifies procedural duration and intravenous fluid administration as significant contributing factors.
- Provides a more nuanced understanding of hematological responses to angiocardiography, aiding in clinical management and research.
Purpose:
Children's blood changes during angiocardiography may not be only due to the contrast media (CM).
Methods:
We studied the presence and severity of changes in those parameters in 35 pediatric patients undergoing angiocardiography with ioxaglate aiming to identify independent variable responsible for those changes. Blood samples were taken at the beginning of the procedure (SI), at the end (S2) and two hours later (S3).
Results:
Hematocrit: S1 = 47.3 +/- 6.9%; S2 = 40.7 +/- 7.4% (p < 0.001), (related to the CM volume r=0.37, (p < 0.05). Hemoglobin: S1 = 15 +/- 2.1g%; S2 = 13.2 +/- 2.4g% (p < 0.001), and S3 = 12.7 +/- 2.5g% (NS). White blood cell count: S1 = 7940 +/- 3040 leukocytes/mm3; S2 = 6950 +/- 2700/mm3 (NS); S3 = 10830 +/- 4690 leukocytes/mm3 (p < 0.001). Procedure duration (r = 0.83, p < 0.05) and 5% glucose fluid given between S2 and S3 (r = 0.49, p < 0.05) were isolated. Sodium: S1 = 134.5 +/- 0.4mEq/L, S2 = 130.7 +/- 0.4mEq/L (p < 0.001) (due to 5% glucose fluid injected, r = 0.61, p < 0.01). Potassium: S1 = 4.22 +/- 0.45mEq/L, S2 = 300.6 +/- 13.3mOsm/kg (p < 0.001). Calcium: S1 = 9.13 +/- 1.03mg%; S2 = 8.4 +/- 0.91 mg/dL. (related to the CM, r = 0.43, p < 0.01.) Osmolality: S1= 293.3 +/- 12.5mOsm/kg; S2 = 3.83 +/- 0.4mEq/L (p<0.001). Viscosity: S1 = 3.36 +/- 0.81; S2 = 3.09 +/- 0.74 (p < 0.01); S3 = 3.87 +/- 0.89, p < 0.001. There was an indirect linear regression with the CM.
Conclusion:
There were profound differences among the dependent variables observed but the ioxaglate was partially related to changes in hematocrit/hemoglobin, total calcium and viscosity. We failed to demonstrate significant regression coefficient between CM and changes in leukocytes, sodium, potassium, and osmolality.
