EFFECT OF ANGIOCARDIOGRAPHY ON FLUID AND ELECTROLYTE BALANCE

¹ From the Departments of Radiology and Pediatrics, New York Hospital-Cornell University Medical Center, New York, New York

A study of the effects of contrast material on fluid and electrolyte balance was carried out in 33 patients between the ages of 1 month and 18 years who underwent diagnostic cardiac catheterization and angiocardiography. Thirteen patients were under 1 year of age and 14 were cyanotic. A total of 53 individual studies were performed, with 20 patients undergoing 2 angiocardiographies. Serum sodium, chloride, potassium, bicarbonate, osmolality, blood urea nitrogen, pH, hemoglobin and hematocrit were measured immediately before the injection of Hypaque-M 75 per cent and within 5 minutes after, and at 15, 30, and 180 minutes thereafter. The study revealed a sharp rise in the serum osmolality with a similar sharp fall in the hematocrit and the pH. These findings suggest a marked dilutional and acidotic effect occurring within 5 minutes of injection. These changes were profound and it is suggested that more than 20 minutes should be allowed between angiocardiographies, if repeated studies are to be carried out, in order to allow for a recovery period from the acute biochemical insult produced by contrast media upon fluid and electrolyte balance.

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