Laude E A, Emery C J, Morcos S K
Department of Respiratory Medicine, Sheffield University Medical School, UK.
Br J Radiol. 1998 Nov;71(851):1143-8. doi: 10.1259/bjr.71.851.10434908.
Respiratory adverse reactions have been reported with the use of contrast media. This study investigates the effects of different radiographic contrast media (RCM) on ventilation and blood gases. Tidal volume and respiratory rate of male Wistar rats anaesthetised with Inactin (100 mg kg-1 intraperitoneally), were measured continuously by integration of tracheal airflow. Contrast media (diatrizoate 370, ioxaglate 320 and iopromide 300) or mannitol controls matched for volume, pH and osmolarity (4 ml kg-1) were administered via a jugular cannula (n > or = 6 per group). Carotid artery blood was sampled at 2, 7, 12, 17, 25 and 30 min post-injection for PaO2, PaCO2 and pH. Systemic blood pressure was monitored from the same cannula. No significant reduction was observed in minute ventilation (tidal volume x respiratory rate per minute) with any of the contrast media. All contrast media and control solutions produced a fall in PaO2 within 4 min; returning to basal levels at 10 min (diatrizoate 35.6% (p < 0.05), ioxaglate 15.2% (p < 0.02), iopromide 16.2% (p < 0.01); controls: 17.3% (p < 0.01), 13.5% (p < 0.02) and 12.0% (NS), respectively). The fall in PaO2 induced by diatrizoate was significantly (p < 0.05) larger in comparison to the other groups. Ioxaglate, iopromide and their mannitol controls induced a comparable fall in PaO2. There was a concurrent rise in PaCO2 and fall in pH that reached significance for diatrizoate (p < 0.01). The changes in blood gases with RCM administration cannot be explained by changes in ventilation and may be due to an effect on pulmonary perfusion.
使用造影剂时曾有呼吸不良反应的报道。本研究调查了不同的放射造影剂(RCM)对通气和血气的影响。用安泰酮(100毫克/千克腹腔注射)麻醉的雄性Wistar大鼠的潮气量和呼吸频率,通过整合气管气流进行连续测量。通过颈静脉插管给予造影剂(泛影葡胺370、碘克沙醇320和碘普罗胺300)或等体积、pH值和渗透压匹配的甘露醇对照剂(4毫升/千克)(每组n≥6)。在注射后2、7、12、17、25和30分钟采集颈动脉血样,检测动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)和pH值。通过同一插管监测体循环血压。使用任何一种造影剂后,分钟通气量(潮气量×每分钟呼吸频率)均未观察到显著降低。所有造影剂和对照溶液在4分钟内均使PaO2下降;在10分钟时恢复到基础水平(泛影葡胺下降35.6%(p<0.05),碘克沙醇下降15.2%(p<0.02),碘普罗胺下降16.2%(p<0.01);对照剂分别下降17.3%(p<0.01)、13.5%(p<0.02)和12.0%(无统计学意义))。与其他组相比,泛影葡胺引起的PaO2下降显著更大(p<0.05)。碘克沙醇、碘普罗胺及其甘露醇对照剂引起的PaO2下降程度相当。PaCO2同时升高,pH值下降,泛影葡胺组达到显著水平(p<0.01)。给予RCM后血气的变化不能用通气变化来解释,可能是由于对肺灌注的影响。