Sakuma I, Sakuma K, Fukao M, Akaishi Y, Asajima H, Sato M, Shudo H, Numazawa K, Kakinoki S, Kitabatake A
Department of Cardiovascular Medicine, Hokkaido University School of Medicine.
Kokyu To Junkan. 1993 Dec;41(12):1191-5.
Effects on circulating blood volume (CBV) of the intravenous injection of a nonionic contrast medium, ioversol, with various doses were assessed in order to find a way of injection with less effects on systemic circulation. Ioversol was injected as a bolus to 20 mongrel dogs at doses of A: 3.75 ml/kg (n = 8) or B: 2 ml/kg (n = 6) of a solution containing 320 mg iodine per ml, or C: 2 ml/kg (n = 6) of a 240 mgI/ml solution. Colloid oncotic pressure (COP) of the bloods drawn before and 1, 2, 3, 5 min after the injection of ioversol was measured by a needle type osmometer, and changes in CBV were calculated using the COP values. Upon injection of ioversol CBV increased rapidly and then gradually returned to the preinjection levels. The change in CBV induced by ioversol was significantly less than those reportedly induced by an ionic contrant medium, iothalamate, and a nonionic medium, iopamidol, and comparable to that by another nonionic medium, iohexol. The degree of increase in CBV and the blood concentration of ioversol were related to the amount, but not the volume, of ioversol injected. Thus, ioversol proved to be one of the low osmotic nonionic contrast media with less effects on CBV. Furthermore, it is suggested that the amount, rather than volume, of contrast medium should be taken into consideration when the angiography of the patients with reduced cardiac function, children or aged patients is performed in whom the contrast medium-induced CBV expansion needs to be as less as possible.
为了找到一种对体循环影响较小的注射方式,评估了静脉注射不同剂量的非离子型造影剂碘佛醇对循环血容量(CBV)的影响。将碘佛醇以推注方式注射到20只杂种犬体内,剂量分别为:A组,每毫升含320毫克碘的溶液3.75毫升/千克(n = 8);B组,每毫升含320毫克碘的溶液2毫升/千克(n = 6);C组,每毫升含240毫克碘的溶液2毫升/千克(n = 6)。在注射碘佛醇前及注射后1、2、3、5分钟抽取血液,用针式渗透压计测量血液的胶体渗透压(COP),并使用COP值计算CBV的变化。注射碘佛醇后,CBV迅速增加,然后逐渐恢复到注射前水平。碘佛醇引起的CBV变化明显小于据报道离子型造影剂碘肽葡胺和非离子型造影剂碘帕醇引起的变化,与另一种非离子型造影剂碘海醇相当。CBV的增加程度和碘佛醇的血药浓度与注射的碘佛醇量有关,而非体积。因此,碘佛醇被证明是对CBV影响较小的低渗非离子型造影剂之一。此外,对于心功能减退的患者、儿童或老年患者进行血管造影时,由于需要尽可能减少造影剂引起的CBV扩张,建议应考虑造影剂的量而非体积。