Extrinsic warming of low-osmolality iodinated contrast media to 37°C reduced the rate of allergic-like reaction. Zhang Bin,Liu Jing,Dong Yuhao,Guo Baoliang,Lian Zhouyang,Yu Hui,Luo Xiaoning,Mo Xiaokai,Zhang Lu,Huang Wenhui,Ouyang Fusheng,Li Xinyun,Liang Changhong,Zhang Shuixing Allergy and asthma proceedings Although there is good evidence that warming of contrast media changes the bolus kinetics and injection pressure of iodinated contrast media, there has been little evidence that it affects clinical adverse event rates in a meaningful way. To determine whether the extrinsic warming of low-osmolality iodinated contrast media to 37°C reduced adverse reactions. Data on adverse reactions were collected from two cohorts, one of which used contrast media at room temperature and the other in which contrast media were warmed to 37°C before administration. Adverse reactions, including allergic-like and physiological reactions, were reviewed. We compared the incidence rates of adverse reactions between the two cohorts by using the χ2 test. A total of 70,446 injections in cohort 1 and 203,873 injections in cohort 2 were included. Extrinsic warming reduced the rate of allergic-like reactions to iopromide 370, iopamidol 370, and iohexol 350 (0.32% in cohort 1 versus 0.21% in cohort 2, p = 0.003; 0.14% versus 0.10%, p = 0.046; and 0.32% versus 0.13%, p = .003, respectively). However, the physiological reaction rates could not be reduced (p = 0.057, p = 0.107, and p = 0.962, respectively). The extrinsic warming of iopromide 300 could not reduce adverse reaction rates (allergic-like reaction rates: 0.21% versus 0.16%, p = 0.407; physiological reaction rates: 0.17% versus 0.13%, p = 0.504). Extrinsic warming to 37°C before intravenous administration was associated with a reduction in the rate of allergic-like reactions to iopromide 370, iopamidol 370, and iohexol 350. 10.2500/aap.2018.39.4160

Relationship between viscosity and determined injection pressure in angiography catheters for common roentgen contrast media. Dyvik K,Dyrstad K,Tronstad A Acta radiologica. Supplementum The viscosity of 8 commercially available contrast media (CM) at 2 or 3 concentrations were measured as a function of concentration and temperature, using a rotational viscosmeter. Further on, by use of an automated injector, injection pressures were measured for 3 of the CM at various concentrations, temperatures, catheter lengths, catheter diameters and flow rates. The experiments were performed as fractional factorial designs. The correlation between the injection pressure and the viscosity was found to be log-linear, and an empiric equation was established for this relationship. The relative reduction of viscosity - and therby injection pressure - with increasing injection temperature, was largest for the most concentrated CM. Iodixanol and iotrolan, the 2 nonionic dimers investigated, demonstrated an increased viscosity compared to the nonionic monomers at equal concentrations. However, all CM investigated could be used with an acceptable injection pressure either by relatively small changes in catheter conditions or by adjustment of injection temperature closer to body temperature. 10.1177/0284185195036s39906

Physicochemical properties of iodixanol. Eivindvik K,Sjogren C E Acta radiologica. Supplementum Iodixanol, the radiopaque in Visipaque, is a new nonionic, dimeric roentgen contrast medium for intravascualr use. Compared to aqueous solutions of nonionic monomers, which have higher osmolality than blood, aqueous solutions of iodixanol have a lower osmolality due to dimeric structure of the molecule. As a consequence of this advantageous property, solutions of all clinical concentrations of iodixanol can be made isotonic by the addition of salts of the key electrolytes sodium and calcium to the formulation. The viscosity of all iodixanol (Visipaque) solutions is less than or equal to that of iohexol (Omnipaque) 350 mg I/ml. Iodixanol itself is an amorphorus and hygroscopic solid which is freely soluble in water. Partition coefficients show that iodixanol is even more hydrophilic than the nonionic monomers such as iohexol. The high hydrophilicity and the good aqueous solubility of iodixanol are due to the hydroxyl group in the dimer linkage and the hydrophilic amide side chains of the molecule. 10.1177/0284185195036s39904

Formulation, stability and compatibility of iodixanol. Aars E V,Eivindvik K Acta radiologica. Supplementum Iodixanol (Visipaque) is an isotonic, electrolyte-balanced roentgen contrast medium for intravascular use. The patented and well-proven formulation and the rationale for it are described, and the efficacy and safety are documented. The stability of iodixanol is well within the specifications under all relevant conditions, both in glass and polypropylene bottles; the product has a recommended shelf-life of at least 36 months when stored at room temperature and protected from light. Heating to body temperature before use is acceptable and recommendable, and storage at 37 degress C for 1 month does not jeopardize product quality. Iodixanol has no apparent immediate in vitro incompatibility reactions with drugs often used in connection with roentgen contrast examinations. 10.1177/0284185195036s39907