iothalamate-meglumine and Pulmonary-Edema

The objective of this study was to determine the short- and long-term radiographic, physiologic and histologic changes elicited in the lung of rabbits following the aspiration of commonly used radiographic contrast agents. All agents used, including nonionic agents, caused radiographically evident pulmonary edema which cleared by 24 hours. The contrast materials with higher osmolality, viscosity, and iodine content elicited the greatest physiologic and pathologic changes. No differences were found between an ionic and a nonionic agent with similar viscosities and iodine content, despite a lower osmolality in the nonionic agent. No contrast agent is innocuous when introduced into the lung.

Topics: Animals; Bronchi; Contrast Media; Diatrizoate Meglumine; Instillation, Drug; Iohexol; Iothalamate Meglumine; Lung; Osmolar Concentration; Pulmonary Edema; Rabbits

Topics: Adult; Anaphylaxis; Female; Humans; Iothalamate Meglumine; Pulmonary Edema

A case of severe anaphylactoid reaction following injection of intravenous contrast is described, and a discussion of the treatment of severe allergic reactions follows. The patient's presentation was unusual in that she rapidly developed massive non-cardiac pulmonary edema as the primary symptom, along with hypotension and hypokalemia, a syndrome similar to adult respiratory distress syndrome. The development of the reaction along with the unusual presentation is discussed and a detailed discussion of the generalized treatment of anaphylactoid and anaphylactic reactions is presented. Additionally, several errors in management that may have delayed resolution of the symptoms and prolonged the period of instability in the patient's condition are discussed and critiqued.

Topics: Acute Disease; Anaphylaxis; Critical Care; Drug Therapy, Combination; Female; Humans; Hypokalemia; Hypotension; Iothalamate Meglumine; Middle Aged; Pulmonary Edema

Topics: Adult; Aged; Angiography; Arterial Occlusive Diseases; Femoral Artery; Humans; Injections, Intra-Arterial; Iothalamate Meglumine; Middle Aged; Osmolar Concentration; Pulmonary Edema

5 patients developed pulmonary oedema after retrograde femoral arteriography under general anesthesia. Because of the haemodynamic changes associated with radiographic contrast media, a good preoperative cardiological assessment is essential. The volume and nature of the contrast media injected and any other fluid administered should be carefully monitored. There is no apparent safe maximum dose of radiographic contrast media, but this work suggests that for 'Conray 420' (sodium iothalamate 70% w/v) a total dose should be less than 200 ml in a fit patient. The dose should be substantially smaller in patients with a history of evidence of myocardial infarction, myocardial insufficiency, myocardial ischaemia, or hypertension.

Topics: Acute Disease; Adult; Aged; Angiography; Dose-Response Relationship, Drug; Femoral Artery; Humans; Intermittent Claudication; Iothalamate Meglumine; Middle Aged; Pulmonary Edema

Topics: Angiography; Animals; Contrast Media; Diatrizoate; Diatrizoate Meglumine; Dogs; Humans; Iothalamate Meglumine; Pulmonary Edema

Topics: Adolescent; Angiocardiography; Arrhythmias, Cardiac; Bronchial Spasm; Cardiac Catheterization; Child; Contrast Media; Cough; Dyspnea; Geriatrics; Headache; Heart Defects, Congenital; Humans; Hypotension; Infant; Infant, Newborn; Iothalamate Meglumine; Iothalamic Acid; Mortality; Pulmonary Edema; Taste; Toxicology; Urticaria; Vomiting