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Effect of Iodinated Contrast Media on Serum Electrolyte Concentrations in Patients Undergoing Routine Contrast
Sindhu Sankaran1, Gautom Kumar Saharia1, Suprava Naik2
1Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India.
Insights
Iodinated contrast media significantly alters serum sodium and chloride levels in adults, likely due to hemodilution. Physicians should monitor electrolytes post-contrast administration.
Area of Science:
- Nephrology
- Radiology
- Clinical Chemistry
Background:
- Iodinated contrast media (ICM) are hypertonic, potentially causing fluid and electrolyte shifts.
- Existing data on ICM's effect on serum electrolytes is conflicting.
- This study addresses the discrepancy by evaluating electrolyte changes post-ICM administration.
Purpose of the Study:
- To evaluate changes in serum electrolyte concentrations (sodium, potassium, chloride, ionized calcium) after intravenous ICM administration in adults.
- To correlate electrolyte changes with patient demographic profiles.
- To investigate the impact of ICM on electrolyte balance.
Main Methods:
- Prospective observational clinical study involving 103 adult patients.
- Blood samples collected before and 24 hours after contrast-enhanced computed tomography (CECT).
- Serum electrolytes measured using an ion-selective electrode analyzer.
Main Results:
- Significant decreases observed in serum sodium and chloride concentrations post-ICM administration.
- Mean sodium levels decreased from 136.29 ± 3.53 to 132.49 ± 6.36 mmol/L.
- Mean chloride levels decreased from 100.03 ± 0.70 to 97.53 ± 0.70 mmol/L.
- Females exhibited a greater decrease in sodium concentration compared to males.
- Hemodilution secondary to contrast osmolality is the probable cause.
Conclusions:
- Physicians must be vigilant for potential electrolyte disturbances after ICM administration.
- Prompt recognition and management of adverse electrolyte events are crucial.
- Understanding ICM's impact on electrolytes aids in patient safety during radiological procedures.
Background And Objectives:
Being hypertonic solutions, iodinated contrast media such as iohexol can cause a shift of fluids and electrolytes between different compartments of the body, but there is an ongoing discrepancy in data and current studies as to the effect of iodinated contrast media on serum electrolytes. Hence, this hospital-based prospective clinical observational study was carried out with objectives of evaluating the changes in serum electrolyte concentrations with intravenous iodinated contrast media administration in adult population and to correlate the changes in electrolyte concentrations, if any, with the demographic profile of the patients.
Materials And Methods:
We analyzed 103 numbers of adult patient samples over a period of 2 months by collecting blood both before administration of contrast and after 24 h of the contrast-enhanced computed tomography scan procedure. Serum concentrations of sodium, potassium, chloride, and ionized calcium were measured using Eschweiler Combiline analyzer based on ion-selective electrode principle.
Results:
The mean age of the study population in our study was 40.11 ± 20.51 years. We found that changes in serum sodium and chloride concentration after administration of contrast media are significant (sodium: 136.29 ± 3.53 vs. 132.49 ± 6.36 mmol/L and chloride: 100.03 ± 0.70 vs. 97.53 ± 0.70 mmol/L). Sodium concentration shows more decrease in females compared to males after administration of iodine contrast. The most probable reason for this decrease in serum electrolytes was secondary changes to hemodilution due to high osmolality of the contrast.
Conclusions:
Attending physicians must be alert for such possibilities of changes in electrolytes after contrast administration and be prepared to treat any adversity if one occurs.
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