Hemodynamic effects and image quality of low-osmolar ionic and nonionic contrast media during pulmonary angiography

Abstract

We compared the hemodynamic responses to ionic and nonionic low-osmolar contrast media of patients who underwent pulmonary angiography. Ninety-nine consecutive patients with suspected pulmonary emboli were randomly assigned to receive either 40 ml iohexol or 40 ml ioxaglate in 2 sec at 600 psi (0.17 kg/m2). Mean pulmonary arterial pressure, pulse rate, and blood pressure were recorded before, immediately after, and 2, 5, and 10 min following injection. Image quality was assessed by readers who were unaware of drug assignment. Pulmonary arterial pressure increased to a maximum at 2 min and was higher in patients with pulmonary emboli (p = .06). There were no significant differences between the two contrast media used. The systolic blood pressure and pulse rate in patients with pulmonary emboli increased significantly more in the ioxaglate group (ps = .03 and .04, respectively). Image quality was excellent in 90% of both groups. Both contrast agents are safe for pulmonary angiography and yield similar image quality. There appears to be a positive inotropic effect of ioxaglate.