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contrast media

  • side-effects from high osmolality / viscosity (fluid shifts from different compartments)
    • vasodilatation
    • heat
    • pain
    • osmotic diuresis
    • hemodynamic changes
  • pharmacokinetics
    • distribute volume into extracellular space
    • clearance by glomerular filtration and renal excretion
  • physiologic reaction
    • increased plasma osmolality causes fluid shift from RBCs and pulmonary tissue leading to increased plasma volume
    • then osmolar gradient reverses with passage of contrast bolus -> pulmonary capillary endothelium leaks protein into pulm interstitium --> increased pulmonary edema
    • transient cardiovascular changes (magnitude increased with tonicity of medium)
      • increased PAP
      • increased CO with decreased peripheral/pulmonary vascular resistance
      • decreased systemic arterial pressure (variable)
    • may activate gen receptors causing side effects

Ruth Carlos, MD  -  10 January 1996
Last updated:  1 October 2013


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