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Assessment of the accuracy of blood drawn from peripheral venous cannula used for infusing intravenous fluids/ drugs versus direct venepuncture to analyse full blood counts in febrile children. The Ceylon medical journal INTRODUCTION:Blood sampling is a common occurrence in current paediatric practice. Dengue and other febrile illnesses are the main disease entities attributable to admissions. These admissions warrant repeated blood sampling especially with regard to full blood counts. Repeated direct pricking for sampling or having an in-situ cannula for bleeding purposes both have their own disadvantages and undesirable effects. OBJECTIVES:Compare the accuracy of parameters of full blood count of a blood sample taken from a cannula in use against a full blood count from a direct prick. METHOD:Nine parameters of the full blood count were compared in 38 paired blood samples from each subject of a cohort of febrile children aged 1-14 years admitted to Professorial Paediatric Unit of Colombo South Teaching Hospital, Kalubowila, Sri Lanka. Samples were taken when medically indicated only. RESULTS:The mean values of MCV and MCHC from direct venepuncture vs cannula sample were statistically different. Other parameters did not show a statistically significant difference between the samples collected by the two methods. CONCLUSION:Blood sampling from a cannula in use for intravenous fluids or medications is favourable for majority of parameters of the full blood count and an advantageous alternative for fresh venepuncture bleeding in febrile children. 10.4038/cmj.v66i2.9466
Analytical interference of intravascular contrast agents with clinical laboratory tests: a joint guideline by the ESUR Contrast Media Safety Committee and the Preanalytical Phase Working Group of the EFLM Science Committee. European radiology The Contrast Media Safety Committee of the European Society of Urogenital Radiology has, together with the Preanalytical Phase Working Group of the EFLM Science Committee, reviewed the literature and updated its recommendations to increase awareness and provide insight into these interferences. CLINICAL RELEVANCE STATEMENT: Contrast Media may interfere with clinical laboratory tests. Awareness of potential interference may prevent unwanted misdiagnosis. KEY POINTS: • Contrast Media may interfere with clinical laboratory tests; therefore awareness of potential interference may prevent unwanted misdiagnosis. • Clinical Laboratory tests should be performed prior to radiological imaging with contrast media or alternatively, blood or urine collection should be delayed, depending on kidney function. 10.1007/s00330-023-10411-x
Analytical Interference by Contrast Agents in Biochemical Assays. Otnes Sigrid,Fogh-Andersen Niels,Rømsing Janne,Thomsen Henrik S Contrast media & molecular imaging Objective:To provide a clinically relevant overview of the analytical interference by contrast agents (CA) in laboratory blood test measurements. Materials and Methods:The effects of five CAs, gadobutrol, gadoterate meglumine, gadoxetate disodium, iodixanol, and iomeprol, were studied on the 29 most frequently performed biochemical assays. One-day-old plasma, serum, and whole blood were spiked with doses of each agent such that the gadolinium agents and the iodine agents reached concentrations of 0.5 mM and 12 mg iodine/mL, respectively. Subsequently, 12 assays were reexamined using 1/2 and 1/4 of these CA concentrations. The results were assessed statistically by a paired Student's -test. Results:Iodixanol produced a negative interference on the bicarbonate ( = 0.011), lactate dehydrogenase ( < 0.0001), and zinc ( = 0.0034) assays and a positive interference on the albumin ( = 0.0062), calcium ( < 0.0001), ionized calcium ( = 0.0086), iron ( < 0.0001), and potassium ( = 0.0003) assays. Iomeprol produced a negative interference on the bicarbonate ( = 0.0057) and magnesium ( = 0.0001) assays and a positive interference on the calcium ( < 0.0001) and potassium ( = 0.0012) assays. Gadoxetate disodium produced a negative interference on the iron ( < 0.0001) and zinc ( < 0.0001) assays and a positive interference on the sodium ( = 0.032) assay. Conclusion:CAs cause analytical interference. Attention should be given to the above-mentioned analyte-CA combinations when assessing laboratory blood test results obtained after CA administration. 10.1155/2017/1323802
In which patients should serum creatinine be measured before iodinated contrast medium administration? Thomsen Henrik S,Morcos Sameh K, European radiology Routine measurement of serum creatinine before injection of intravascular iodinated contrast material in all patients would be cumbersome and have an associated cost. There is doubt about whether serum creatinine should be measured routinely in all patients or selectively. The Contrast Media Safety Committee of the European Society of Urogenital Radiology decided to review the literature and draw up guidelines on this important practical issue. A literature search was carried out and summarized in a report. Based on the available information and discussions amongst the members of the Committee, guidelines were produced. The report and guidelines were discussed at the 11th European Symposium on Urogenital Radiology in Santiago de Compostela, Spain. The practice for identifying patients at risk of contrast medium induced nephropathy varies considerably from one institution to another. Patients at risk constitute only a small percentage of all cases referred for contrast enhanced imaging examination. However, it is important to identify them and take the necessary precautions. Recent serum creatinine level should be available in patients with an increased probability of a raised serum creatinine level (renal disease, renal surgery, proteinuria, diabetes mellitus, hypertension, gout, current intake of nephrotoxic drugs). A simple guideline has been produced. 10.1007/s00330-004-2591-y
Venipuncture versus peripheral catheter: do infusions alter laboratory results? Hambleton Victoria Lerma,Gómez Ignacio Arribas,Andreu Francisco A Bernabeu Journal of emergency nursing INTRODUCTION:Our aim was to evaluate the equivalence between analytic parameters from blood samples obtained from a saline solution lock device used for the infusion of drugs and those from venipuncture. In our emergency department, patients bearing a saline solution lock device have blood extracted by venipuncture to avoid possible contamination of the sample. METHODS:Adults from the emergency department with a saline solution lock device who required laboratory tests were selected as candidates for this cross-sectional observational study. Infusions were halted and flushed with 0.9% saline solution; 2 minutes later, 2 mL of blood was drawn and discarded, and the corresponding laboratory tubes were filled. Immediately after, another sample was withdrawn from the opposite extremity by venipuncture. Both samples were analyzed for hematology, biochemistry, venous blood gases, and coagulation parameters. Concordance was evaluated by use of the intraclass correlation coefficient with its 95% confidence intervals; Bland-Altman plots were used to illustrate the percentage of samples with differences exceeding 2 SDs. The mean differences were also checked to detect those exceeding the laboratory's systematic error. RESULTS:An intraclass correlation coefficient of over 0.9 was achieved for all parameters except for pH, partial pressure of carbon dioxide, and partial pressure of oxygen. Differences of over 2 SDs were found in fewer than 10% of all parameters. None of them exceeded 3 SDs, except for pH and venous blood gases. All parameters showed differences below the laboratory's accepted systematic error except for pH and venous blood gases. DISCUSSION:Blood samples extracted from a peripheral catheter with or without drug infusions are valid for the analysis of hematology, biochemistry, and coagulation parameters but not for venous blood gases. Nurses should know the benefits of using an existing peripheral catheter for drawing blood samples for laboratory analysis even when infusing commonly used drugs. Emergency nurses should consider collecting blood specimens from a venous access device regardless of the type of drug infusions administered, because it is a safe, simple, and fast technique, which is time efficient when treating patients with limited venous access sites. This procedure reduces patient discomfort and the risk of complications related to venipunctures. 10.1016/j.jen.2012.03.014
The reliability of blood sampling from peripheral intravenous infusion lines. Complete blood cell counts, electrolyte panels, and survey panels. Mohler M,Sato Y,Bobick K,Wise L C Journal of intravenous nursing : the official publication of the Intravenous Nurses Society To assess the accuracy of venous blood sampling obtained from peripheral intravenous infusion lines, peripheral saline locks, and by peripheral venipuncture, dual blood samples from 55 hospitalized patients were compared for test reliability. Tests included complete blood cell counts, electrolyte studies, and general survey panels. Results showed that within certain limitations, blood sampling from a wide range of peripheral indwelling devices is reliable for many routine blood tests.
Data regarding blood drawing sites in patients receiving intravenous fluids. Watson K R,O'Kell R T,Joyce J T American journal of clinical pathology Intravenous fluids were infused into the forearms of 18 volunteers. Baseline hematologic and serum biochemical profiles were obtained from each volunteer prior to starting the IV. After the intravenous fluids had infused for 30 minutes, blood was drawn from the opposite arm, and above and below the IV in the same arm. The intravenous fluids were then stopped, and after waiting two minutes, another blood sample was drawn from the IV needle. The deviation from the baseline value was determined for each analyte by sampling site for each volunteer and the mean deviation was calculated for each analyte from each sample site. Drawing blood from above the infusing IV line resulted in a dilutional effect for most of the analytes. Most analytes were not affected when blood was drawn from the other sites. Serum glucose and phosphorus had mean deviations greater than two standard deviations from the baseline, regardless of where they were drawn. Serum glucose was the only analyte with values higher than the baseline values. We recommend that serum biochemical and hematologic profiles not be drawn above an infusing IV, but should be drawn from the opposite arm or below the IV while it is infusing or out of the IV needle after the intravenous fluids have been stopped for two minutes. 10.1093/ajcp/79.1.119
The central blood volume as measured by thoracic electrical impedance and plasma proANP is not compromised by donation of 900 mL of blood in men. Gybel-Brask Mikkel,Nordsborg Nikolai Baastrup,Goetze Jens P,Johansson Pär I,Secher Niels H,Bejder Jacob Transfusion medicine (Oxford, England) OBJECTIVES:To evaluate whether the donation of 900 mL of blood reduces the central blood volume (CBV) assessed by thoracic electrical impedance (TI) and plasma pro-atrial natriuretic peptide (proANP). BACKGROUND:Donation of 450 mL of blood carries a 1% risk of a vasovagal reaction. Withdrawal of 900 mL of blood decreases cardiac output; however, the effect on CBV remains unknown. METHODS/MATERIALS:A randomised, single-blinded, placebo-controlled, crossover design was used, where 21 healthy semi-recumbent men donated 2 × 450 mL blood or were sham-phlebotomised. Changes in CBV were estimated by proANP and TI at 1.5 (TI ) and 100 (TI ) kHz, reflecting extracellular volume and (regional) total body water, respectively, and the index value (IDX; 1/T -1/TI ) was used to estimate changes in intracellular (red cell) volume. Systolic, diastolic and mean arterial blood pressure; heart rate; stroke volume; cardiac output; and systemic vascular resistance were monitored. After completion of the study, 1000 mL of isotonic saline was infused. RESULTS:Changes (mean% ± SD) in TI , TI and IDX were similar after 450 mL (-0.2 ± 1.6%, 0.0 ± 1.1%, -0.4 ± 10.1%) and 900 mL (0.1 ± 1.6%, 0.2 ± 1.5% and -2.0 ± 15.8%) of blood donation compared to after a sham donation of 450 mL (-0.9 ± 1.2%, -0.5 ± 1.5% and -0.1 ± 6.1%) and 900 mL (-1.2 ± 1.5%, -0.6 ± 1.3% and 0.5 ± 9.9%). In addition, changes in plasma proANP were similar after 450 and 900 mL of blood donation (-0.8 ± 6.7% and -7.6 ± 7.9%) as after sham donations (1.3 ± 7.3% and -4.5 ± 5.6%). Monitoring haemodynamic variables revealed that stroke volume decreased after the donation of 900 mL of blood (-12 ± 12 mL) compared to sham donations. CONCLUSION:During a 900-mL blood loss in semi-recumbent men, CBV measured by TI and plasma proANP is not affected. 10.1111/tme.12727
Blood sampling from peripherally inserted central catheter is effective and safe for patients with head and neck cancers. The journal of vascular access OBJECTIVE:To evaluate the validity of laboratory tests for blood sampling from a peripherally inserted central catheter. METHODS:A total of 22 patients diagnosed with head and neck cancers were enrolled. In total, 101 paired blood samples were taken both via venipuncture and peripherally inserted central catheter for hematology and biochemistry testing. Paired t tests and linear correlation analysis were used to evaluate the results. Blood sampling-related pain was recorded by visual analogue scales and numerical rating scales. Infusion occlusion, hemolysis, and catheter-related blood stream infection were also recorded. RESULTS:The peripherally inserted central catheter-associated test results were slightly lower than those with venipuncture. Some parameters differed more than others. However, the degree of difference was less than 5% for every pair. There was a high correlation between the test results with two methods of blood sampling with the representative equation approximately being "y = x." According to visual analogue scales and numerical rating scale analysis, the pain degree with peripherally inserted central catheter was significantly lower than that of the venipuncture (p < 0.001). No case of infusion occlusion, catheter-related blood stream infection was reported with both methods. Hemolysis rate in blood samples from peripherally inserted central catheter (1/101) was much lower than that seen with venipuncture (11/101) with significant difference (p = 0.0056). CONCLUSION:Blood sampling via peripherally inserted central catheter and venipuncture showed equivalent reliability in laboratory testing. Compared with venipuncture, blood sampling via peripherally inserted central catheter causes less pain and is safer. Blood sampling via peripherally inserted central catheter is strongly recommended for clinical use. 10.1177/1129729820943458
Contrast Media Ioversol Interferes with Urinalysis. Clinical laboratory BACKGROUND:Ioversol is a commonly used non-ionic radiological contrast media in medical imaging to enhance the visualization of blood vessels, tissues, or organs. However, if it is not completely excreted, ioversol can interfere with urinalysis and lead to abnormal test results. METHODS:This study reported a case where the contrast media ioversol interfered with Sysmex UN automated urine analyzer. RESULTS:UC-3500 displayed no test results except the error code "0401". UF-4000 indicated "abnormally high RBCs" and no parameter results. CONCLUSIONS:Urine specimens containing contrast media are considered unqualified samples. Urinalysis should be performed only after the patient has completely excreted the contrast media. 10.7754/Clin.Lab.2023.230661
Comparison of Safety and Diagnostic Efficacy of Iohexol 240 mgI/mL, Iopamidol 250 mgI/mL, and Iodixanol 270 mgI/mL in Cerebral Angiography: A Prospective, Multicenter Study. Neurointervention PURPOSE:This multicenter prospective study aimed to evaluate the quality and diagnostic effectiveness of cerebral angiography images obtained using low-concentration iodinated contrast agents (iohexol 240 mgI/mL, iopamidol 250 mgI/mL, and iodixanol 270 mgI/mL) and to assess the safety thereof. The study addresses the need for safer contrast agent alternatives without compromising the diagnostic quality of identifying cerebrovascular disease. MATERIALS AND METHODS:Conducted in 5 medical centers in South Korea, we enrolled patients aged 19 years or older who were referred for diagnostic cerebral angiography under non-emergency conditions, excluding those with specific health conditions and sensitivities. The study design included a prospective, observational approach with a 1-way analysis of variance (ANOVA) for sample size calculation, aiming for a total sample of 231 participants for adequate power. Image quality was evaluated using a 4-level scale by 2 independent, blinded radiologists, and adverse reactions were monitored both immediately and up to 7 days post-procedure. Statistical analysis involved 1-way ANOVA and Kruskal-Wallis tests to assess the image quality and safety profiles of the contrast agents. RESULTS:Among 266 patients screened, 243 were included in the final analysis. The evaluation revealed no statistically significant differences in image quality among the 3 types of low-concentration contrast agents. Adverse events were observed in 28.8% of patients, with 27.2% experiencing acute reactions, primarily mild reactions, and 3.3% experiencing delayed reactions. The overall safety profile showed no significant changes in vital signs or electrocardiogram readings before and after contrast agent injection. CONCLUSION:Using low-concentration iodinated contrast agents for cerebral angiography provides image quality comparable to that of conventional high-concentration agents, with no significant increase in adverse events, suggesting a safer alternative for patients. 10.5469/neuroint.2024.00129
Iodinated Contrast Medium Affects Urine Cytology Assessment: A Prospective, Single-Blind Study and Its Impact on Urological Practice. Diagnostics (Basel, Switzerland) During endoscopic procedures for suspected urothelial tumors of the upper urinary tract, radiographic imaging using an iodinated contrast medium is often required. However, following ureteropyelography, we detected changes in cytology characteristics not correlating with real cytology findings in naive urine. The aim of our study was to assess cytology changes between naive and postcontrast urine according to The Paris System of cytology classification. We prospectively assessed urine samples from 89 patients (23 patients with histologically proven urothelial cancer and 66 healthy volunteers). The absence of malignancy was demonstrated by CT urography and/or ureteroscopy. The study was single blind (expert cytopathologist) and naïve Paris system for urine cytology assessment was used. Furthermore, additional cytological parameters were analyzed (e.g., specimen cellularity, degree of cytolysis, cytoplasm and nucleus color, chromatin and nucleo-cytoplasmic ratio). Our study showed statistically significant differences when comparing naïve and postcontrast urine in healthy volunteers (only 51 % concordance, = 0.001) versus malignant urine specimens (82 % concordance). The most important differences were in the shift from The Paris System category 2 (negative) to 1 (non-diagnostic) and from category 2 (negative) to 3 (atypia). Other significant changes were found in the assessment of specimen cellularity ( = 0.0003), degree of cytolysis ( = 0.001), cytoplasm color ( = 0.003), hyperchromasia ( = 0.001), course chromatin ( = 0.002), nucleo-cytoplasmatic ratio ( = 0.001) and nuclear borders' irregularity ( = 0.01). Our unique study found crucial changes in the cytological assessment of naive and postcontrast urine and we confirm that postcontrast urine is more often assessed as abnormal, suspect or non-diagnostic. Therefore, before urine collection for cytology, the clinician should avoid administration of iodinated contrast into the urinary tract. 10.3390/diagnostics12102483
Effects of Low-Osmolar Contrast Media on Long-Term Renal Impairment After Coronary Angiography: Iohexol Versus Iopromide. The American journal of cardiology To investigate the long-term effects of 2 commonly used low-osmolar contrast media, iohexol and iopromide, on renal function and survival in patients who underwent coronary angiography. A total of 14,141 cardiology patients from 2006 to 2013 were recruited, of whom 1,793 patients (679 patients on iohexol and 1,114 on iopromide) were evaluated for long-term renal impairment and 5,410 patients (1,679 patients on iohexol and 3,731 on iopromide) were admitted for survival analyses spanning as long as 15 years. Univariate and multivariate logistic regression were used to explore the risk factors for long-term renal impairment. Cox proportional hazard regression was used to investigate the risk factors affecting survival. Propensity score matching and inverse probability of treatment weighting were applied to balance the baseline clinical characteristics. Patients receiving iohexol demonstrated a greater occurrence of renal impairment compared with those who received iopromide. Such difference remained consistent both before and after propensity score matching or inverse probability of treatment weighting, with a statistical significance of p <0.05. Among clinical variables, receiving contrast-enhanced contrast tomography/magnetic resonance imaging during follow-up, antihypertensive medication usage, presence of proteinuria, and anemia were identified as risk factors for long-term renal impairment (p = 0.041, 0.049, 0.006, and 0.029, respectively). During survival analyses, the difference was insignificant after propensity score matching and inverse probability of treatment weighting. In conclusion, administration of iohexol was more likely to induce long-term renal impairment than iopromide, particularly among patients diagnosed with anemia and proteinuria and those taking antihypertensive medication and with additional contrast exposure. The all-cause mortality, however, showed no significant difference between iohexol and iopromide administration. 10.1016/j.amjcard.2023.11.029
Effects of two types of medical contrast media on routine chemistry results by three automated chemistry analyzers. Park Yu Jin,Rim John Hoon,Yim Jisook,Lee Sang-Guk,Kim Jeong-Ho Clinical biochemistry OBJECTIVES:The use of iodinated contrast media has grown in popularity in the past two decades, but relatively little attention has been paid to the possible interferential effects of contrast media on laboratory test results. Herein, we investigate medical contrast media interference with routine chemistry results obtained by three automated chemistry analyzers. METHODS:Ten levels of pooled serum were used in the study. Two types of medical contrast media [Iopamiro (iopamidol) and Omnipaque (iohexol)] were evaluated. To evaluate the dose-dependent effects of the contrast media, iopamidol and iohexol were spiked separately into aliquots of serum for final concentrations of 1.8%, 3.6%, 5.5%, 7.3%, and 9.1%. The 28 analytes included in the routine chemistry panel were measured by using Hitachi 7600, AU5800, and Cobas c702 analyzers. We calculated the delta percentage difference (DPD) between the samples and the control, and examined dose-dependent trends. RESULTS:When the mean DPD values were compared with the reference cut-off criteria, the only uniformly interferential effect observed for all analyzers was in total protein with iopamidol. Two additional analytes that showed trends toward interferential effects only in few analyzers and exceeded the limits of the allowable error were the serum iron and the total CO. The other combinations of analyzer and contrast showed no consistent dose-dependent propensity for change in any analyte level. CONCLUSIONS:Our study suggests that many of the analytes included in routine chemistry results, except total protein and serum iron, are not significantly affected by iopamidol and iohexol. These results suggest that it would be beneficial to apply a flexible medical evaluation process for patients requiring both laboratory tests and imaging studies, minimizing the need for strict regulations for sequential tests. 10.1016/j.clinbiochem.2017.02.023
CT and X-ray contrast agents: Current clinical challenges and the future of contrast. Acta biomaterialia Computed tomography (CT) is a powerful and widely used imaging technique in modern medicine. However, it often requires the use of contrast agents to visualize structures with similar radiographic density. Unfortunately, current clinical contrast agents (CAs) for CT have remained largely unchanged for decades and come with several significant drawbacks, including serious nephrotoxicity and short circulation half-lives. The next generation of CT radiocontrast agents should strive to be long-circulating, non-toxic, and non-immunogenic. Nanoparticle contrast agents have shown promise in recent years and are likely to comprise the majority of next-generation CT contrast agents. This review highlights the fundamental mechanism and background of X-ray and contrast agents. It also focuses on the challenges associated with current clinical contrast agents and provides a brief overview of potential future agents that are based on various materials such as lipids, polymers, dendrimers, metallic, and non-metallic inorganic nanoparticles (NPs). STATEMENT OF SIGNIFICANCE: We realized a need for clarification on a number of concerns related to the use of iodinated contrast material as debates regarding the safety of these agents with patients with kidney disease, shellfish allergies, and thyroid dysfunction remain ongoing in medical practice. This review was partially inspired by debates witnessed in medical practice regarding outdated misconceptions of contrast material that warrant clarification in translational and clinical arenas. Given that conversation around currently available agents is at somewhat of a high water mark, and nanoparticle research has now reached an unprecedented number of readers, we find that this review is timely and unique in the context of recent discussions in the field. 10.1016/j.actbio.2023.09.027
Uptake of Gadolinium-Based Contrast Agents by Blood Cells During Contrast-Enhanced MRI Examination. Investigative radiology OBJECTIVES:Gadolinium-based contrast agents (GBCAs) are routinely used in magnetic resonance imaging (MRI) examinations. However, there is limited knowledge about the interaction with and distribution of the drug in human cells. This lack of knowledge is surprising, given that the first interaction of the drug occurs with blood cells. Moreover, recent studies reported gadolinium (Gd) deposition within organs, such as the brain. Hence, this study is aiming to determine the uptake of GBCA in blood cells of patients undergoing contrast-enhanced MRI (ce-MRI) examination. MATERIALS AND METHODS:Human blood was exposed to either gadoterate meglumine (Gd-DOTA) or Eu-DOTA in vitro or was collected from patients undergoing ce-MRI with Gd-DOTA. Uptake of contrast agents (CAs) by blood cells was quantified by Gd measurements using single-cell inductively coupled plasma mass spectrometry (SC-ICP-MS) or, to confirm Gd-DOTA uptake, by a complementary method using Eu-DOTA by time-resolved fluorescence spectroscopy, respectively. RESULTS:Uptake of Gd-DOTA or Eu-DOTA into white blood cells (WBCs) ex vivo was detectable by SC-ICP-MS and time-resolved fluorescence spectroscopy. The intracellular concentrations were estimated to be in the range of 1-3 μM. However, no CA uptake into erythrocytes was detected with either method. In total, 42 patients between 30 and 84 years old (24 men, 18 women) were enrolled. White blood cells' uptake of Gd was measured by SC-ICP-MS. Isolated WBCs from patients who underwent ce-MRI examination showed substantial Gd uptake; however, the studied patient group showed an inhomogeneous distribution of Gd uptake. Measurements immediately after MRI examination indicated 21-444 attogram/WBC, corresponding to an intracellular Gd concentration in the range from 0.2 to 5.5 μM. CONCLUSIONS:This study confirms the ex vivo uptake of GBCA by WBCs and provides the first evidence that GBCA is indeed taken up by WBCs in vivo by patients undergoing ce-MRI examination. However, the observed Gd uptake in WBCs does not follow a log-normal distribution commonly observed in the fields of environmental studies, biology, and medicine. Whether cellular uptake of GBCA is linked to the observed deposition of Gd remains unclear. Therefore, studying the interaction between GBCA and human cells may clarify crucial questions about the effects of Gd on patients after MRI examinations. 10.1097/RLI.0000000000001029
How Do Contrast Agents Affect Cardiac Markers and Coagulation Tests? Experimental Study. Tascanov Mustafa Begenc,Gönel Ataman Combinatorial chemistry & high throughput screening BACKGROUND:The discovery that biotin interferes with results of troponin and Nt-proBNP led some commercial firms to update their measurement methods. In particular, the clinical incompatibility of cardiac test results may affect the risk of morbidity and mortality. OBJECTIVE:The aim of this study is to investigate the interference effects of 7 different contrast agents on cardiac markers (Troponin-I, Nt-proBNP, Mass CK-MB, CK, AST, LDH) and in coagulation tests (PT, APTT). METHODS:Seven different contrast media were added into control materials by using interference protocol. The concentrations of PT, APTT, CK, AST, LDH, Mass CK-MB, Troponin-I, and Nt-proBNP were measured by Sysmex CS-2100, Abbott c16000, Siemens Centaur XP and AFİAS-6 analyzer. The number of deviations from target values was calculated. RESULTS:The 7 different contrast media caused negative interference in troponin levels between 57.43% and 62.87%. It was found that different contrast media produced false negativity in the Nt-proBNP test, ranging from 6.11% to 96.01%. Enzymes and coagulation tests were less affected. CONCLUSION:Different contrast media may cause false negatives in cTnI and Nt-proBNP. The contrast medium that causes the least interference should be preferred. The results of samples taken in the first hour after contrast imaging should be interpreted with care. 10.2174/1386207322666190603170438