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Sodium-calcium balance in nonionic contrast media. Effects on the risk of ventricular fibrillation in the isolated rabbit heart

Bååth, Lars LU ; Besjakov, Jack LU and Oksendal, A (1993) In Investigative Radiology 28(3). p.223-227
Abstract
RATIONALE AND OBJECTIVES. During coronary arteriography the blood is replaced for a short period of time with a contrast medium (CM) solution. The CM may cause a risk of arrhythmias and ventricular fibrillation (VF). Previous investigations have shown that the addition of small amounts of sodium (10-30 mmol/L) to nonionic CM may decrease the risk of VF from these media. Calcium addition to nonionic CM may reduce a negative inotropic effect. In the current investigation, the changed risk of VF from nonionic CM with 19 to 30 mmol/L NaCl was studied when the media also contained calcium or calcium and magnesium. METHODS. An isolated rabbit heart model was used. The risk of arrhythmias and VF from the nonionic monomer iohexol and the nonionic... (More)
RATIONALE AND OBJECTIVES. During coronary arteriography the blood is replaced for a short period of time with a contrast medium (CM) solution. The CM may cause a risk of arrhythmias and ventricular fibrillation (VF). Previous investigations have shown that the addition of small amounts of sodium (10-30 mmol/L) to nonionic CM may decrease the risk of VF from these media. Calcium addition to nonionic CM may reduce a negative inotropic effect. In the current investigation, the changed risk of VF from nonionic CM with 19 to 30 mmol/L NaCl was studied when the media also contained calcium or calcium and magnesium. METHODS. An isolated rabbit heart model was used. The risk of arrhythmias and VF from the nonionic monomer iohexol and the nonionic dimer iodixanol containing 19 to 30 mmol/L NaCl with 0 to 2.5 mmol/L calcium as CaCl2 was studied. In the series with iodixanol, 0 to 0.95 mmol/L MgCl2 also was added to the solutions with sodium and calcium, but the role of magnesium was not especially evaluated in the investigation. RESULTS. Nonionic CM with small amounts of NaCl (19-30 mmol/L), without calcium or with calcium at the level of 0.05 to 0.3 mmol/L, caused the lowest risk of VF. When relatively higher additions of calcium reached the physiologic concentration of 2.5 mmol/L, the CM caused a greater risk of arrhythmias and VF. CONCLUSIONS. When calcium is added to a nonionic CM, the concentration of calcium must be balanced against the NaCl concentration to minimize the risk of VF. Excessive calcium concentration will increase the risk of VF. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Investigative Radiology
volume
28
issue
3
pages
223 - 227
publisher
Lippincott Williams & Wilkins
external identifiers
  • pmid:8486488
  • scopus:0027247664
ISSN
0020-9996
language
English
LU publication?
yes
id
28a9ffb0-30ba-4f01-bc18-4652ddd6f6bb (old id 1107479)
date added to LUP
2008-07-31 09:48:03
date last changed
2017-01-01 05:03:01
@article{28a9ffb0-30ba-4f01-bc18-4652ddd6f6bb,
  abstract     = {RATIONALE AND OBJECTIVES. During coronary arteriography the blood is replaced for a short period of time with a contrast medium (CM) solution. The CM may cause a risk of arrhythmias and ventricular fibrillation (VF). Previous investigations have shown that the addition of small amounts of sodium (10-30 mmol/L) to nonionic CM may decrease the risk of VF from these media. Calcium addition to nonionic CM may reduce a negative inotropic effect. In the current investigation, the changed risk of VF from nonionic CM with 19 to 30 mmol/L NaCl was studied when the media also contained calcium or calcium and magnesium. METHODS. An isolated rabbit heart model was used. The risk of arrhythmias and VF from the nonionic monomer iohexol and the nonionic dimer iodixanol containing 19 to 30 mmol/L NaCl with 0 to 2.5 mmol/L calcium as CaCl2 was studied. In the series with iodixanol, 0 to 0.95 mmol/L MgCl2 also was added to the solutions with sodium and calcium, but the role of magnesium was not especially evaluated in the investigation. RESULTS. Nonionic CM with small amounts of NaCl (19-30 mmol/L), without calcium or with calcium at the level of 0.05 to 0.3 mmol/L, caused the lowest risk of VF. When relatively higher additions of calcium reached the physiologic concentration of 2.5 mmol/L, the CM caused a greater risk of arrhythmias and VF. CONCLUSIONS. When calcium is added to a nonionic CM, the concentration of calcium must be balanced against the NaCl concentration to minimize the risk of VF. Excessive calcium concentration will increase the risk of VF.},
  author       = {Bååth, Lars and Besjakov, Jack and Oksendal, A},
  issn         = {0020-9996},
  language     = {eng},
  number       = {3},
  pages        = {223--227},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Investigative Radiology},
  title        = {Sodium-calcium balance in nonionic contrast media. Effects on the risk of ventricular fibrillation in the isolated rabbit heart},
  volume       = {28},
  year         = {1993},
}