Dennhardt, Nils;
Schoof, Stephan;
Osthaus, Wilhelm A.;
Witt, Lars;
Bertram, Harald;
Sümpelmann, Robert
Alterations of acid–base balance, electrolyte concentrations, and osmolality caused by nonionic hyperosmolar contrast medium during pediatric cardiac catheterization
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Medientyp:
E-Artikel
Titel:
Alterations of acid–base balance, electrolyte concentrations, and osmolality caused by nonionic hyperosmolar contrast medium during pediatric cardiac catheterization
Beteiligte:
Dennhardt, Nils;
Schoof, Stephan;
Osthaus, Wilhelm A.;
Witt, Lars;
Bertram, Harald;
Sümpelmann, Robert
Erschienen:
Wiley, 2011
Erschienen in:
Pediatric Anesthesia, 21 (2011) 11, Seite 1119-1123
Sprache:
Englisch
DOI:
10.1111/j.1460-9592.2011.03706.x
ISSN:
1155-5645;
1460-9592
Entstehung:
Anmerkungen:
Beschreibung:
SummaryObjective: 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 pCO2, 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.