Systemic Hypotension Following Intravenous Administration of Nonionic Contrast Medium During Computed Tomography
Autor: | Daniel Putzer, Hanno Ulmer, Franz-Josef Wiedermann, Peter Schullian, Gerlig Widmann, Wolfgang Lederer, Reto Bale |
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Rok vydání: | 2018 |
Předmět: |
Adult
Male Mean arterial pressure Iohexol medicine.medical_treatment Contrast Media 030204 cardiovascular system & hematology 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Double-Blind Method Triiodobenzoic Acids Heart rate medicine Humans Prospective Studies Saline Aged business.industry Iopromide Middle Aged Iodixanol Contrast medium Anesthesiology and Pain Medicine Blood pressure Anesthesia Administration Intravenous Female Hypotension Tomography X-Ray Computed business Perfusion Follow-Up Studies medicine.drug |
Zdroj: | Anesthesia & Analgesia. 126:769-775 |
ISSN: | 0003-2999 |
Popis: | In light of the increasing number of radiologic interventions performed under general anesthesia, the effects of contrast media (CM) on circulation and organ perfusion are of paramount importance. The objectives of this study were to systematically quantify effects on blood pressure, heart rate, and kidney function following intravenous administration of nonionic CM with normal and low osmolality.In this controlled, double-blinded phase IV clinical trial, 40 consecutive patients were randomly assigned to receive repeated measures of either low-osmolar iopromide or iso-osmolar iodixanol. Normal saline solution (NSS) served as control. Blood pressure and heart rate were measured continuously from 1 minute before until 3 minutes after administration of CM and NSS. Urine output was recorded hourly.Administration of iopromide resulted in systemic hypotension lasting up to 300 seconds (105 ± 61 seconds) with the lowest mean arterial pressure of 39 mm Hg (56.7 ± 12.2 mm Hg). Iopromide caused a systolic/diastolic decrease of 31/26 mm Hg (P.001), significant increase in heart rate (P = .042), and significant diuresis with a 2-fold higher per-hour urine output (P = .010). Administration of iodixanol and NSS had no significant influence on blood pressure (P.640).Administration of low-osmolar iopromide was followed by a significant transient decrease in blood pressure and a rise in heart rate. Anesthetists and radiologists should be aware of these effects in patients in whom short episodes of disturbed tissue microcirculation may pose a clinical risk. |
Databáze: | OpenAIRE |
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