Effect Of Radiologic Contrast Agents On Laboratory Parameters Used In The Evaluation Of Hemostatic Function

1981 ◽  
Author(s):  
Z Parvez ◽  
J Fareed ◽  
R Moncada ◽  
P Agrawal ◽  
H L Messmore
Keyword(s):  
Contrast Media ◽  
Contrast Agents ◽  
Anticoagulant Therapy ◽  
Laboratory Tests ◽  
Diagnostic Procedures ◽  
Study Patient ◽  
Thrombin Time ◽  
Coagulation Disorders ◽  
Transient Effects ◽  
Clotting Factors

Coagulation disorders of the intrinsic and extrinsic pathways are monitored by measuring such clotting times as partial thromboplastin time (PTT), prothrombin time (PT), and thrombin time (TT). These laboratory tests reflect the congenital and acquired deficiencies of clotting factors and are used for controlling anticoagulant therapy. We have previously reported that meglumine (cation) in radiologic contrast media (CM) inhibits factor VIII, IX, and thrombin (Fed. Proc. 36 (3), 317, 1977) and consequently prolonges clotting times. The effects of ionic and nonionic CM on pathological plasma were investigated by employing routine clotting assays. Patient plasmas showing PT values >15 secs., were mixed with Renografin-60 (Squibb and Sons, Princeton, New Jersey), P-297, iothalamic acid, and ioxigalic acid (Laboratoire Guerbet, Paris, France) and PTs were then determined. Renografin-60 (30 mg/ml), iothalamic acid (10 mg/ml) and ioxigalic acid (10 mg/ml) produced an increase in the PT values by 60-80% base levels, whereas no such effect was seen with P-297. In normal plasma (NHP), the PT values were elevated only by 5-10%. In another study, patient plasmas showing PTT > 40 secs., were supplemented with CM and the mixtures were assayed for PTT. Except with P-297 there was a 50-60% increase in PTT due to the interactions of ionic CM. Our studies show that during anticoagulant therapy, if clotting assays are performed immediately after radiologic diagnostic procedures, utilizing intravascular contrast agents, erroneous conclusions can be drawn. Our studies have also shown that certain ionic CM can produce transient effects on coagulation parameters and therefore, due consideration be given to the presence of these agents in patients suffering from platelet function defects and other coagulation disorders.

scholarly journals A Comparison of the Anticoagulant Actions of Commercially Available Contrast Media (CM)

1977 ◽  
Author(s):  
Rogelio Moneada ◽  
Jawed Fareed ◽  
Harry Messmore ◽  
Terrence Demos
Keyword(s):  
Sodium Chloride ◽  
Contrast Media ◽  
Toluidine Blue ◽  
Partial Thromboplastin Time ◽  
Antithrombin Iii ◽  
Thrombin Time ◽  
Clotting Factors ◽  
Antithrombin Activity ◽  
Viii And Ix

Previous studies have reported on the anticoagulant effect of commercially available contrast media used in diagnostic radiology. The purpose of this study is to compare the anticoagulant actions of these agents in vitro. Eight commercially available contrast medias were supplemented to citrated human plasma (CNP) in 1:10, 1:20 and 1:50 proportions; isomolar sucrose, glucose, sodium chloride, and saline supplemented CNP were used as controls. Prothrombin time (FT) , partial thromboplastin time (PTT), thrombin time (TT), antithrombin-III, plasminogenplasnun and factor assays were performed at 0 time, 30 minutes and 2 hours after incubation at 37°C. No significant alteration of the coagulation parameters were observed at 1:50 dilution, however at 1:10 and 1:20 dilution, most contrast media produced aberration of clotting parameters. The antithrombin potency of these contrast media at a 1:10 dilution ranged from 0.3-1.3 u/ml heparin. In addition, this antithrombin activity was synergistic with heparin. The antithrombin activity of these agents was not neutralized by protamine sulfate, polybrene or toluidine blue in the amounts which neutralized 1 u/ml heparin. Analysis of various clotting factors revealed that factors II, V, VII and XII were not affected by contrast media. Factors VIII and IX were depressed significantly. These changes were mainly dependent on the concentration of meglumine in the contrast media. Similar studies on the blood obtained from patients infused with contrast media for diagnostic purposes are in progress in our laboratory.

Nonionic Low-Osmolar Monomeric Iodinated Contrast Material: Some Aspects of use for Computed Tomography in Children

2017 ◽  
pp. 118-129
Author(s):  
I. A. Kondrashov ◽  
V. Mandal
Keyword(s):  
Computed Tomography ◽  
Contrast Agents ◽  
Adverse Reactions ◽  
Contrast Material ◽  
Iodine Content ◽  
Diagnostic Procedures ◽  
Diagnostic Efficacy ◽  
Minimum Risk ◽  
Electrical Neutrality ◽  
Iodinated Contrast

Iodine containing contrast media are used much frequently now-a-days for computed tomography examinations in children. The group of non-ionic monomers occupies a special place among modern contrast agents. Low osmolarity and viscosity, electrical neutrality and the highest iodine content of these contrast materials provide the best diagnostic efficacy with minimum risk of adverse reactions. However, characteristic anatomic and physiological aspects of a growing child’s body require additional attention and care during diagnostic procedures with use of such contrast agents. This article presents concise literature review of recent years highlighting practical aspects of nonionic lowosmolar iodinated contrast material use for computed tomography assisted diagnostic examinations in child population.

scholarly journals Endometriosis as a Reason of Intraabdominal Bleeding in Pregnancy. Clinical Case

2019 ◽  
Vol 23 (3) ◽  
pp. 283-289
Author(s):  
Y. A. Revzoeva ◽  
E. Y. Shakurova
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Laboratory Tests ◽  
Clinical Case ◽  
Abdominal Cavity ◽  
Diagnostic Procedures ◽  
Reproductive Period ◽  
Diagnostic Methods ◽  
Dark Blood ◽  
Abdominal Bleeding

The article defines the significance and relevance of the problem of endometriosis during pregnancy. 10% of women in the reproductive period have different localization of endometriosis. 25% of pregnancies with endometriosis are complicated by preterm labor. The article presents a clinical case of intra-abdominal bleeding in a 28-year-old pregnant woman with retrocervical endometriosis at gestation age of 32 weeks and 6 days. The article covers the results of examination and special diagnostic procedures of intra-abdominal bleeding in pregnant women with retrocervical endometriosis. The main diagnostic methods were the study of past medical history, ultrasound examination, and laboratory tests. Due to their infrequency during pregnancy internal bleedings present difficulties in their diagnosis. Ultrasound reliably revealed a large amount of fluid in the abdominal cavity and small pelvis and excluded the presence of intrauterine bleeding. Clinical and laboratory tests indicated the severity of the patient's condition. Symptoms of moderate fetal distress were also identified. Therefore, a decision was made about an emergency delivery by the cesarean section followed by an abdominal revision. During the cesarean section, 500 ml of blood in the form of dark blood clots was found in the abdominal cavity. The condition of the premature newborn was in conformity with his gestational age. The source of bleeding were the of endometriosis on the back wall of the uterus. These focuses most likely caused hemoperitoneum. The revision of the abdominal cavity did not find any other foci of bleeding. The postoperative period was uneventful. The article provides general guidelines for the management of pregnant women with severe forms of endometriosis.

Effects of Intravenous Injection of Diatrizoate, Iohexol or Ioxilan on Renal Size, Urine Profiles and Blood Profiles in the Rabbit

1988 ◽  
Vol 29 (4) ◽  
pp. 491-494 ◽  
Author(s):  
H. Rygaard ◽  
S. Dorph ◽  
H. S. Thomsen ◽  
T. Mygind ◽  
H. Nielsen ◽  
...  
Keyword(s):  
Contrast Media ◽  
Contrast Agents ◽  
Immunofluorescence Microscopy ◽  
Control Group ◽  
Digital Subtraction ◽  
Gradual Decline ◽  
Glucose Phosphate ◽  
Average Maximum ◽  
Renal Size ◽  
Blood Profiles

Diatrizoate, iohexol or ioxilan were injected intravenously in 18 rabbits. The contrast medium passage through the kidneys was recorded on digital subtraction images for the first 50 s followed by 100 mm exposures up to 15 min after injection. The renal area was measured planimetrically. Urine profiles (glucose, phosphate, LDH, GGT, NAG), blood profiles (potassium, urea) and the relative clearance of albumin and sodium were followed for 5 days and compared with a control group injected with saline. All kidneys were examined by light and immunofluorescence microscopy. All three contrast media produced excellent arteriograms and urograms. The three different contrast media caused a rapid increase of the kidney area within the first minute, reaching an average maximum of 10 to 12 per cent after 5 min, followed by a gradual decline. Contrary to expectations the increase in renal area was similar for all three contrast media, so hyperosmolality is no likely explanation of this phenomenon. None of the contrast agents caused significant changes in any of the profile components with one exception: the GGT excretion was significantly elevated during the first 24 h after diatrizoate administration as compared with the effect of saline. Light and immunofluorescence microscopy revealed no differences.

scholarly journals Coagulation and Bleeding Disorders: Review and Update

2000 ◽  
Vol 46 (8) ◽  
pp. 1260-1269 ◽  
Author(s):  
Douglas A Triplett
Keyword(s):  
Laboratory Tests ◽  
Platelet Adhesion ◽  
Vascular Wall ◽  
Activated Partial Thromboplastin Time ◽  
Thrombin Time ◽  
Bleeding Disorders ◽  
Coagulation Proteins ◽  
Hereditary Disorders ◽  
Von Willebrand ◽  
Willebrand Factor

Abstract Hemostasis is initiated by injury to the vascular wall, leading to the deposition of platelets adhering to components of the subendothelium. Platelet adhesion requires the presence of von Willebrand factor and platelet receptors (IIb/IIIa and Ib/IX). Additional platelets are recruited to the site of injury by release of platelet granular contents, including ADP. The “platelet plug” is stabilized by interaction with fibrinogen. In this review, I consider laboratory tests used to evaluate coagulation, including prothrombin time, activated partial thromboplastin time, thrombin time, and platelet count. I discuss hereditary disorders of platelets and/or coagulation proteins that lead to clinical bleeding as well as acquired disorders, including disseminated intravascular coagulation and acquired circulating anticoagulants.

scholarly journals Effect of contrast media on urinary cytopathology specimens

2016 ◽  
Vol 10 (7-8) ◽  
pp. 228 ◽  
Author(s):  
Sebastian Frees ◽  
Samir Bidnur ◽  
Michael Metcalfe ◽  
Peter Raven ◽  
Claudia Chavez-Munoz ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Urinary Tract ◽  
Contrast Media ◽  
Contrast Agents ◽  
Urothelial Carcinoma ◽  
Urinary Cytology ◽  
Cancer Model ◽  
Hydropic Degeneration ◽  
Bladder Cell ◽  
Bladder Cancer Model

<p><strong>Introduction:</strong> Urological dogma dictates that washings collected from the urinary tract for cytological assessment must be performed without interference from contrast agents that may alter cellular integrity and diagnostic interpretation. In practice, the initial contrast used to outline the upper tracts is commonly discarded with subsequent saline washings sent for cytology. We hypothesize that contrast washings do not affect the morphology of urothelial carcinoma cells or the integrity of cytology interpretation.</p><p><strong>Methods:</strong> Samples obtained from (1) human bladder cell lines; (2) urine from a human xenograft bladder cancer model using UC-3 cells; and (3) patients with urothelial carcinoma were subjected to various experimental solutions (water, saline, urine, and dilutions of contrast media) for different exposure times. After exposure to various different solutions, samples underwent cytological analysis to assess morphologic and degenerative changes.</p><p><strong>Results:</strong> No cytological differences were seen when cells were exposed to ionic, hyperosmolar, or non-ionic low-osmolar contrast agents for any exposures up to five minutes. Cells exposed to mixtures of contrast agents and urine also demonstrated no evidence of degenerative change. Cells exposed to water for greater than one minute demonstrated significant hydropic degeneration impacting cytological interpretation. At 40 minutes or later, all reagents caused severe degeneration when evaluating urine samples from the mouse bladder cancer model and from patients undergoing urothelial carcinoma.</p><p><strong>Conclusions:</strong> Commonly used contrast agents have no effect on urinary cytology up to five minutes. Contrast washings of the urinary tract should not be discarded and can be sent for cytological diagnosis if fixed within this time period.</p>

scholarly journals Nephrogenic systemic fibrosis (NSF) and gadolinium-based contrast media

2013 ◽  
Vol 17 (3) ◽  
pp. 106-107
Author(s):  
P.S. Ngoya ◽  
Z Vawda ◽  
J.W Lotz
Keyword(s):  
Renal Failure ◽  
Contrast Media ◽  
Contrast Agents ◽  
Nephrogenic Systemic Fibrosis ◽  
Overwhelming Majority ◽  
Tissue Fibrosis ◽  
Systemic Disorder ◽  
High Doses

Nephrogenic systemic fibrosis (NSF), unknown before March 1997 and first described in 2000, is a systemic disorder characterised by widespread tissue fibrosis. The first known case occurred in 1997, after the use of gadolinium-based contrast agents (GBCAs) at high doses in patients with renal failure had become routine. An overwhelming majority occurred within weeks to months after injection of a GBCA. This note comprises guidelines on the prevention of NSF.

Systematic Use Of Heparin In The Continuous Flow Centrifuge (CFC) For Blood Cell Separation

1981 ◽  
Author(s):  
M R Morales ◽  
J Pizzuto ◽  
Ma Reyna ◽  
G Castro
Keyword(s):  
Blood Cell ◽  
Continuous Flow ◽  
Cell Separation ◽  
Reliable Method ◽  
Dosage Level ◽  
Thrombin Time ◽  
Coagulation Disorders ◽  
Time Dilution ◽  
Continuous Flow Centrifuge ◽  
Simultaneous Assessment

To date the use of heparin in the CFC has not been adequately controlled, thus exposing donors and patients to coagulation disorders. For this reason, we decided to evaluate the use of heparin by continuous infusion in dosages that would be modified by a simultaneous assessment of its anticoagulant effect, as shown by the thrombin time dilution test (TTDT).The study was performed during 46 leukopher- esis and 27 plasmapheresis. It was ascertained that heparin is an efficient anticoagulant in the CFC, using the TTDT as an effective and reliable method for its control. The initial dose in leukopheresis is one unit per milliliter of blood during the first hour, then half the dose during the next hour, and then a quarter of the dose until the procedure is completed. A TTDT performed every hour will indicate whether the amount of heparin used should be modified. For plasmapheresis, it is neccesary to establish a specific dose in each instance, using the TTDT as described. In most of the subjects, the anticoagulant level was exactly right. There was no case of bleeding or extracorporeal coagulation of the blood.On the basis of these findings, we recommend the use of heparin in the CFC, applying the results of the TTDT as a guide for its dosage level.

Inhibition of Thrombotic Side Effects of II, VII, IX and X Concentrates

1975 ◽  
Author(s):  
A. J. Johnson ◽  
V. E. Macdonald ◽  
D. Brandt ◽  
S. Middleton ◽  
J. K. Smith
Keyword(s):  
Side Effects ◽  
Antithrombin Iii ◽  
Coagulation Factors ◽  
Thrombin Time ◽  
Average Yield ◽  
Clotting Time ◽  
Clotting Factors ◽  
Partial Activation ◽  
Peg Treatment ◽  
Fractionation Method

Well documented thrombotic side effects of II, VII, IX and X concentrates are thought to be due to spontaneous partial activation of one or more coagulation factors. Using the unactivated PTT method of Kingdon and the thrombin time as global assays of activation, we have confirmed this concept. It has been suggested that heparin should be added to the concentrate, but preparations vary in antithrombin content and activated factor. The amount of heparin for each preparation would have to be titrated in order to neutralize the activated factors without anticoagulating the patient. We sought to extend the range of added heparin without producing an anticoagulant effect, by adding heparin to the concentrates prior to use of the PEG fractionation method to remove the hepatitis antigen. Thus, heparin-activated antithrombin III can inhibit activated clotting factors while residual free heparin is removed by PEG fractionation. When 1 unit of heparin per mg of protein in the concentrate was added prior to PEG treatment, the final products from more than 80 runs on 15 batches (3 major manufacturers) were almost invariably neutral; neither anticoagulated nor activated. The thrombin clotting time, when measured, was 6-24 hours. The average yield with use of the PEG fractionation method was 85%; depending on the initial purity of the concentrate, the final product had an additional purification of 1.0-2.5 X that of the starting material.(Supported in part by USPHS Grant HL 15596 and HRC (N.Y.) 1-681.)

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