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PubMedDate not supplied

A double-blind comparative study of Hexabrix and Renografin-76 in aortography and visceral arteriography.

A diatrizoate compound (Renografin-76) and low osmolality Hexabrix were compared in a double-blind study of 50 adults undergoing arteriographic examination. Subjective and objective assessment of pain reaction for each contrast injection rated lower overall for Hexabrix. Discomfort associated with Renografin was greatest for injections into extremity arteries. Hexabrix showed the least change in serum osmolality. No impairment of renal function was evidenced with either contrast media. No difference in the angiographic quality of the control agents was noted.

Adult↗
PubMedDate not supplied

A double-blind clinical study comparing the safety and efficacy of Hexabrix and Renografin-76 in contrast enhanced computed body tomography.

Hexabrix, a new low osmolality, iodinated contrast medium and the ionic diatrizoate Renografin-76 were studied in a double-blind parallel group comparison to examine safety and efficacy in patients undergoing contrast assisted CT of the liver, spleen and kidney. No significant differences in pulse, respiration and blood pressure before and after injection were noted in the 100 patients studied. Heat sensation in the Hexabrix group was distinctly lower than in those receiving Renografin, but the two groups did not differ with respect to average scores for pain. There was no difference in adverse side effects. Clinical laboratory studies between the groups showed some differences which could not be attributed to the individual contrast agents. While scan quality of both agents was good to excellent, it should be noted that the dose of Hexabrix was not adjusted to compensate for the difference in iodine content (320 mg I/ml vs. 370 mg I/ml for Renografin-76).

Adult↗
PubMedDate not supplied

Comparison of an ionic with a nonionic contrast agent for cardiac angiography. Results of a multicenter trial.

Ionic contrast agents currently used in cardiac angiography are well tolerated but have certain negative effects. In a five-center study of 273 patients undergoing cardiac catheterization, safety and efficacy of the new nonionic contrast agent, iohexol, were compared with that of the standard ionic material, sodium methylglucamine diatrizoate. Contrast injections were made into the left ventricle and left and right coronary arteries in all patients. Left ventricular, systemic arterial and pulmonary capillary wedge pressures, and electrocardiogram lead II were recorded for 2 minutes. Following the first right and first left coronary injection, systemic arterial pressure and electrocardiographic recordings were made for 1 minute. After each subsequent coronary injection, recordings were made for 20 seconds. Both agents were found to be safe and both provided good diagnostic information. Iohexol was seen to cause both less marked overall hemodynamic alterations and a lower incidence of significant changes in pressure and heart rate. Iohexol may have an important role in coronary angiography and left ventriculography, particularly in high-risk patients, because of its lesser effect on heart rate and blood pressure.

Adult↗
PubMed1988

The hemodynamic effects of the administration of ionic and nonionic contrast materials into the pulmonary arteries of a canine model of acute pulmonary hypertension.

Clinical studies have shown pulmonary and right ventricular hypertension to be important factors increasing the risk to patients during pulmonary angiography. This experiment was undertaken to define the hemodynamic changes induced by the administration of contrast material into the pulmonary arteries of dogs with embolic pulmonary hypertension, and to compare the effects of ionic and nonionic agents. Ten closed-chest dogs under light halothan anesthesia were subjected to pulmonary embolization with sephadex microspheres until severe pulmonary hypertension occurred and the cardiac output decreased to 50%-60% of the pre-embolization baseline. Intra-pulmonary injections of contrast material were performed in eight animals while hemodynamic indices were measured. Sodium methylglucamine diatrizoate induced severe, transient, hypotension associated with a large decrease in systemic vascular resistance and little change in the cardiac output. Hypotension is especially undesirable in the presence of pulmonary hypertension because it worsens the preexisting coronary ischemia and compromised right ventricular function. No elevation in mean pulmonary artery pressure was seen, and pulmonary vascular resistance decreased. Iohexol induced milder effects, perhaps because it exerts a less severe systemic vasodilatory effect and is not a negative inotrope. These findings suggest iohexol may be safer in the high risk patient, however, these data may not be directly applied to unanesthetized humans.

Acute Disease↗
PubMed1991

The effects of a hyperosmolar intravenous contrast medium on blood viscosity.

The effects of the hyperosmolar contrast medium, diatrizoate meglumine (Renografin-76) on blood viscosity and other metabolic parameters were measured in 20 immature piglets. Intravenous contrast medium caused a significant (P less than .5) increase in serum osmolality, cardiac output, and urine output, and a decrease in hematocrit. There was a fall in blood viscosity that was not statistically significant. These changes, which are attributed to an acute shift of fluid into the hyperosmolar vascular compartment, were greatest at 3 minutes following injection and subsequently returned towards baseline levels. We conclude that blood viscosity is not increased following intravenous injection of hyperosmolar radiocontrast media.

Animals↗
PubMed1991

Renal clearance of an ionic high-osmolar and a nonionic low-osmolar contrast medium.

One hundred patients with normal serum creatinine concentration underwent intravenous urography with either an ionic high-osmolar (diatrizoate) or a nonionic low-osmolar (iopamidol) contrast medium after randomization. Before injection of the contrast medium, a blood sample was drawn for determinating serum creatinine concentration, and a urine sample for measurement of urine osmolality. Using x-ray fluorescence, the plasma concentration of iodine (contrast medium) was determined on blood samples drawn approximately 3 and 4 hours after injection of the contrast medium. The glomerular filtration rate was calculated by two different formulas: one requiring only a single sample and one requiring at least two samples (standard). There were poor correlations between the standard contrast medium clearance and the serum creatinine concentration, the estimated creatinine clearance (calculated from a nomogram), as well as the urine osmolality. The 3-hour and the 4-hour single-sample values correlated well with the two-sample values for both contrast media. In patients with normal serum creatinine, the glomerular filtration rate determined by measuring the contrast medium concentration in a single plasma sample obtained at 3 hours, is almost identical to the value determined from two samples. Consequently, two samples are unnecessary.

Adult↗
PubMed1991

Electrocardiogram changes during intrauterine injection of ionic contrast medium.

The effect of intrauterine injection of meglumine-sodium diatrizoate 60% on the electrocardiogram was studied in 28 young, healthy women during routine hysterosalpingography. The most important single finding observed was significant QTc prolongation in 25 (90%) out of the 28 women examined. QTc increased from 417 +/- 18 mseconds to 451 +/- 30 mseconds (P less than .001). This effect disappeared rapidly within 2 to 3 minutes. Saline was injected in ten women prior to contrast medium injection in order to exclude direct mechanical dilatatory effect of the injected material. The QTc did not change significantly after saline (418 +/- 18 mseconds). The mechanism involved in the QTc prolongation is not known.

Adult↗
PubMed1998

Effects of radiocontrast and endothelin administration on systolic blood pressure and renal damage in male spontaneously hypertensive and Wistar Kyoto rats with phentolamine-induced adrenergic blockade.

RATIONALE AND OBJECTIVES: The systemic administration of hypertonic solutions may activate the adrenergic system, thus triggering vasomotor reactions that may result in renal failure. In this study, the effects of diatrizoate meglumine sodium radiocontrast agent Hypaque-76 on systolic blood pressure (BP) and renal damage were determined in male spontaneously hypertensive (SH) rats and Wistar Kyoto (WKY) rats under adrenergic blockade. METHODS: The systolic BP was measured in ketamine-anesthetized male SH and WKY rats after administration of saline solution, radiocontrast, or endothelin during adrenergic blockade with phentolamine. Then the left kidney was removed and examined histologically. RESULTS: The fall in systolic BP after phentolamine was not influenced by saline solution or radiocontrast in WKY rats but was restored partially by radiocontrast in SH rats. Endothelin produced an elevation in BP toward baseline levels in both strains. Only moderate renal damage was observed in the kidneys of WKY rats given radiocontrast or endothelin, but very severe damage was produced by these agents in SH rats. CONCLUSIONS: Adrenergic blockade with phentolamine did not prevent the elevation in systolic BP in SH rats by radiocontrast or by endothelin in SH and WKY rats, nor did it protect against renal damage by radiocontrast or by endothelin in SH rats.

Adrenergic alpha-Antagonists↗
PubMed1999

Effects of radiocontrast, mannitol, and endothelin on blood pressure and renal damage in the aging male spontaneously hypertensive rat.

RATIONALE AND OBJECTIVES: The purpose of this research was to study the effects of the radiocontrast medium (CM) Hypaque-76 (diatrizoate meglumine sodium), equiosmolar mannitol, and endothelin on blood pressure and renal damage in a aging male spontaneously hypertensive rat, a small animal model for CM-induced renal damage. The importance of the pressor effect and the high osmolality of CM in producing renal damage was investigated by first reducing the blood pressure with pentobarbital anesthesia, which suppresses sympathetic nervous system activity, then testing the effects of CM, saline, mannitol, and the potent vasoconstrictor endothelin alone and in combination with CM. METHODS: Systolic blood pressure was measured in 14-month-old male rats (1) when awake, (2) after pentobarbital anesthesia, (3) after the administration of saline, CM, mannitol, endothelin, or CM plus endothelin, (4) after awakening the same day, and (5) the following day while awake. Renal damage was quantified by evaluating histopathologically the left kidney removed the day after administration of test substances. RESULTS: The pentobarbital-lowered blood pressure remained depressed after saline and mannitol but rose dramatically after CM, endothelin, and CM plus endothelin. Renal damage, compared with the saline controls, occurred with CM, mannitol, endothelin, and endothelin plus CM. The order of increasing severity was mannitol = CM < endothelin < endothelin plus CM. CONCLUSIONS: The effect of CM on systolic blood pressure is not related to its osmolality. High osmolality, however, appears to be a factor in CM-induced renal damage. Ischemia and direct nephrotoxicity are factors contributing to the renal-damaging effects of CM, mannitol, and endothelin.

Aging↗
PubMed1980

Dynamic computed tomography body scanning.

The performance of 16 consecutive, 3 sec computed tomographic (CT) scans, after the intravenous administration of a bolus of diatrizoate, was found to be useful in evaluating vascular anatomy and organ perfusion in this study. It also appeared to be useful in lesion detection and in accurately defining the extent of disease.

Adult↗
PubMedDate not supplied

Gastrografin versus dilute barium for colonic CT examination: a blind, randomized study.

Fifty patients receiving oral contrast medium the day of their CT examinations were studied to evaluate colonic opacification. Two groups were given small volumes (20 versus 30 ml) of nondilute diatrizoate meglumine/diatrizoate sodium (Gastrografin) the night prior to examination and were compared with groups receiving no contrast medium (control) or a large volume (600 ml) of dilute barium the night prior to examination. Frequency of total colonic opacification was as follows: 30 ml Gastrografin, 92%; 20 ml Gastrografin, 71%; dilute barium, 46%; and control, 9%. Significant artifact was infrequent in all groups. Administration of small volumes of nondilute Gastrografin is a well tolerated, inexpensive, and effective method for opacifying the colon for CT.

Barium Sulfate↗
PubMedDate not supplied

Low dose arterial contrast enhancement for cranial computed tomography in renal insufficiency.

In patients with severe renal insufficiency, the high iodine doses used for intravenous contrast medium enhanced CT can lead to renal injury. To minimize renal toxicity in one such patient, dynamic contrast enhanced CT was performed during right common carotid arterial infusion of 17 ml of 30% diatrizoate meglumine solution. Intense homogeneous contrast enhancement of an otherwise isodense mass permitted a diagnosis of meningioma, with excellent definition of tumor extent.

Diatrizoate↗
PubMedDate not supplied

Atypia of hepatic histiocytes induced by Renografin-60.

Recurrent bouts of abdominal pain in a 12-year-old patient were diagnosed as due to intermittent obstruction of the choledochus. The condition was corrected by choledochostomy. Incidental liver biopsy showed atypia of intrahepatic histiocytes. However, electron microscopy identified associated foreign bodies suspected of being an iodinated compound. Six months later a repeat liver biopsy and extensive search showed no carcinoma present. The hepatic atypia was thought to have been induced by diatrizoate meglumine/diatrizoate sodium (Renografin-60), an iodinated compound (E. R. Squibb, Princeton, NJ, U.S.A.) used during percutaneous transhepatic cholangiography.

Child↗
PubMed1976

Effects of some water-soluble contrast media on the colonic mucosa.

Enemas of various solutions were administered to rats to determine if Gastrografin was specifically irritating to the colonic mucosa. Gastrografin was found to cause considerably more inflammation than Hypaque-25, or barium sulfate. Further studies with hypertonic sorbitol, Renografin-76, and Tween 80 suggested that (a) neither hyperosmolality nor the diatrizoate compound itself were damaging to the colon, and (b) Tween 80 most likely plays a major role in Gastrografin's inflammatory effect.

Animals↗
PubMed1976

Direct chronotropic and dromotropic actions of contrast media: ineffectiveness of atropine in the prevention of bradyarrhythmias and conduction disturbances.

Methyl glucamine sodium diatrizoate (Renografin 76) was directly infused into the isolated arteries to the sino-atrial and atrioventricular nodes of anesthetized dogs, causing a dose-related inhibition of sino-atrial nodal automaticity and atrioventricular nodal conductivity; these effects were not attenuated by autonomic blockade or cervical vagotomy. The important negative chronotropic and dramatropic effects of contrast media used for coronary angiography are direct actions and cannot be effectively blocked by premedication with atropine.

Animals↗
PubMed1977

Effects of contrast media on the conducting system of the heart. Mechanism of action and identification of toxic component.

Infusion of progressive volumes of meglumine sodium diatrizoate (Renografin 76) into the arteries to the sinoatrial and atrioventricular nodes in anesthetized dogs produced a dose rate-dependent decrease in heart rate and an increase in "PR interval." At high dose rates, Renografin 76 caused sinus arrest and complete heart block in 50% and 70% of the animals, respectively. Saline and meglumine solutions (0.939 M) equiosmolar with Renografin 76 produced similar effects. Infusions of metrizamide (equal in iodine content with Renografin 76), dextrose solution (0.939 M), and autologous blood each had substantially less effects. Contrast media have a direct inhibitory action on sinoatrial automaticity and atrioventricular conductivity which is dependent on ionic strength, not iodine content.

Animals↗
PubMed1982

Evaluation of the hemodynamic effects of intravenous administration of ionic and nonionic contrast materials. Implications for deriving physiologic measurements from computed tomography and digital cardiovascular imaging.

The effects of intravenous injection of an ionic contrast material (Renografin-76 [meglumine sodium diatrizoate]) on left ventricular pressure, internal diameter, and wall thickness, and on coronary and femoral hemodynamics were compared with those of a hydrolytically stable nonionic contrast material (iohexol). Renografin-76 caused drastic biphasic changes in left ventricular pressure and dp/dt (rate of change of left ventricular pressure), and moderate changes in end systolic dimension. Iohexol caused little or no change in left ventricular pressure and dimensions. In addition, Renografin-76 caused marked arterial hypotension and large increases in coronary and femoral blood flows, while iohexol caused no significant change in arterial pressure and coronary blood flow, and a mild increase in femoral blood flow. Based on these findings, it is concluded that iohexol is preferable to standard ionic contrast material for deriving basal physiologic information from computed tomographic and digital vascular studies.

Animals↗