Document Detail


Alterations of acid-base balance, electrolyte concentrations, and osmolality caused by nonionic hyperosmolar contrast medium during pediatric cardiac catheterization.
MedLine Citation:
PMID:  21966960     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Objective:  This prospective clinical observational study was conducted to investigate the effects of contrast medium on acid-base balance, electrolyte concentrations, and osmolality in children. Background:  For pediatric cardiac catheterization, high doses of nonionic hyperosmolar contrast medium are widely used. Methods:  Forty pediatric patients (age 0-16 years) undergoing cardiac angiography with more than 3 ml·kg(-1) of nonionic hyperosmolar contrast medium (Iomeprol) were enrolled, and the total amount of the contrast agent given was documented. Before and after contrast medium administration, a blood sample was collected to analyze electrolytes, acid-base parameters, osmolality, hemoglobin, and hematocrit. Results:  After cardiac catheterization, pH, hemoglobin, hematocrit, bicarbonate, base excess, sodium, chloride, calcium, anion gap and strong ion difference decreased, whereas osmolality increased significantly (base excess -1.8 ± 1.8 vs -3.4 ± 2.3, sodium 138 ± 2.9 vs 132 ± 4.1 mm, osmolality 284 ± 5.7 vs 294 ± 7.6 mosmol·kg(-1) , P < 0.01). Seventy-eight percent of the children developed hyponatremia (sodium <135 mm). No changes were seen in pCO(2) , lactate, and potassium levels. Conclusions:  Regarding the differential diagnosis of metabolic disturbances after pediatric cardiac catheterization, low-anion gap metabolic acidosis and hyponatremia should be considered as a possible side effect of the administered contrast medium.
Authors:
Nils Dennhardt; Stephan Schoof; Wilhelm A Osthaus; Lars Witt; Harald Bertram; Robert Sümpelmann
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Paediatric anaesthesia     Volume:  21     ISSN:  1460-9592     ISO Abbreviation:  Paediatr Anaesth     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-10-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9206575     Medline TA:  Paediatr Anaesth     Country:  France    
Other Details:
Languages:  eng     Pagination:  1119-23     Citation Subset:  IM    
Copyright Information:
© 2011 Blackwell Publishing Ltd.
Affiliation:
Department of Anesthesiology, Hannover Medical School, Hannover, Germany  Department of Pediatric Cardiology, Hannover Medical School, Hannover, Germany.
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