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At least 19 recordsLinked to original sources

PubMed1990

Measurement of renal function with iohexol. A comparison of iohexol, 99mTc-DTPA, and 51Cr-EDTA clearance.

The nonionic iodinated contrast medium, iohexol, introduced for clinical urography, is eliminated from the human organism mainly by glomerular filtration. The aim of this study was to analyze the applicability of iohexol for glomerular filtration rate (GFR) measurement by comparing the plasma clearance of iohexol to the plasma clearance of the traditionally employed substances, chromium-51-EDTA and technetium-99m-DTPA. Iohexol concentration was measured by x-ray fluorescence. To analyze for possible acute effect of iohexol on renal function, additional measurements of 99mTc-DTPA clearance were made prior to the injection of iohexol. In 15 patients having clearance values between 30 and 130 ml/min per 1.73 m2, there were close correlations (r = 0.95-0.98) among iohexol, 51Cr-EDTA, and 99mTc-DTPA clearance. No significant acute renal effect of iohexol was demonstrated. It is concluded that measurement of iohexol clearance provides information about GFR that is as valid as measurements of 51Cr-EDTA and 99mTc-DTPA clearance. Thus, it is possible to perform urography and a determination of GFR using a single injection of iohexol.

Adult↗

PubMed1992

Effects of vasoconstrictors on isolated rabbit coronary arteries exposed to isotonic iohexol. Potassium chloride-, histamine-, endothelin-, and prostaglandin-F2 alpha-induced contractions on arteries exposed to iohexol without and with osmotic additions (sodium chloride or glucose).

RATIONALE AND OBJECTIVES: A major effect of contrast media (CM) on coronary vessels is vasodilatation, but occasionally, both ionic and nonionic media may cause coronary artery spasm. The influence of CM on the actions of vasoactive substances is not well known. To investigate the effects on rabbit coronary arteries of an iso-osmolar nonionic CM, iohexol (140 mg I/mL) the vasoconstrictors potassium chloride (KCl), histamine, endothelin, and prostaglandin-F2 alpha (PGF2 alpha) were used. The effects of iohexol with 30 to 150 mM sodium chloride (NaCl) or with 25-50 g/L glucose also were investigated. METHODS: Coronary artery segments were mounted between two L-shaped prongs in tissue baths with buffer solution. Before each investigation, buffer was exchanged with iohexol solution. Increasing concentrations of a vasoconstrictor were added, and the constriction of the vessels was recorded. RESULTS: Iohexol caused a comparatively small inhibition of the contractile effects of histamine and endothelin. This meant little reduction in maximal contraction (Emax), and the concentration of constrictory substance resulting in half maximal contraction (EC50) compared with buffer solution. Iohexol also caused a small reduction in Emax of KCl, but EC50 was significantly lower. Adding NaCl or glucose to iohexol decreased Emax and increased EC50. Iohexol inhibited most of the contractile effect of PGF2 alpha, but adding NaCl increased Emax slightly. CONCLUSIONS: The effects caused by a nonionic CM on coronary arteries cannot be attributed to osmolality alone. The CM influenced the effects of vasoconstrictors to differing degrees, but the inhibition of the CM per se was usually small.

Animals↗

PubMed1992

Comparison of iohexol-240 versus iohexol-300 in abdominal CT.

Forty patients without evidence of liver, kidney, or significant cardiac disease were prospectively divided into two groups of 20, receiving either iohexol-240 or iohexol-300. A contrast load of 150 ml was administered in conjunction with a rapid scanning technique at a preselected, fixed level to include liver, renal cortex, and aorta. Peak enhancement was calculated as change in Hounsfield units (HU) over baseline for each area of interest. Mean peak enhancement and standard deviation were calculated for each organ, and the difference between the means for the two contrast agents was compared using the Student's t test. Differences were not statistically significant with all p values greater than 0.05. Our results suggest iohexol-240 is preferred to iohexol-300 for body computed tomography (CT) due to its lower cost and iodine load without statistically significant change in diagnostic quality of the examination.

Evaluation Studies as Topic↗

PubMed1986

Ascending lower-limb phlebography: a comparative study of Hexabrix 320, iohexol 300 and iohexol 240.

A prospective, randomised study on 60 legs in 45 patients examined by ascending lower-limb phlebography was conducted to compare Hexabrix 320 (May and Baker Ltd), iohexol 300 and iohexol 240. The quality of opacification of the veins, side-effects, cost and amount of contrast agent used were compared. All three agents produced adequate examinations. Iohexol 300 was preferred for its denser opacification. Iohexol 240 was associated with the lowest incidence of side-effects and Hexabrix 320 cost the least per examination.

Female↗

PubMed1991

A single plasma sample method for estimation of the glomerular filtration rate in infants and children using iohexol, I: Establishment of a body weight-related formula for the distribution volume of iohexol.

This study was performed in order to develop a method for estimation of the glomerular filtration rate (GFR) from a single plasma sample based upon the plasma disappearance rate of the non-ionic contrast medium iohexol. The apparent distribution volume for iohexol was measured in 100 infants and children and used for establishment of a weight-related empirical formula for the distribution volume. Using the distribution volume obtained by this formula, a preliminary GFR was calculated from the iodine concentration measured in a plasma sample taken 3 h after injection of iohexol. When this estimate was corrected by another empirically established correction factor, a high degree of agreement was found between a GFR reference method and the 3-h single plasma sample method. In another group of 13 children the 3-h single plasma sample GFR was estimated twice with a 2-day interval, and the day-to-day variations were found to be similar to those obtained with other standard methods.

Adolescent↗

PubMed1986

Use of iohexol in the radiographic diagnosis of ischemic bowel.

This study evaluates the use of iohexol as a radiographic diagnostic contrast agent in normal animals and those with experimental bowel ischemia and obstruction. Eighteen rats and 12 rabbits were gavaged with iohexol in a dose of 7.5 mL/kg using concentrations of 140 mg I/mL (isotonic with blood) or 300 mg I/mL. In addition, four rabbits had intraperitoneal iohexol injection and three were given gastrografin gavage. Experimental groups included normal bowel controls, bowel injury induced by ischemia and alcohol contact, bowel obstruction by ligature, and intraperitoneal injection. Serial abdominal radiographs and plasma concentrations of iohexol were obtained. Iohexol remained stable throughout the gastrointestinal tract, retained its intensity, and was well visualized up to four days after administration. Bowel images were fair at concentrations of 140 mg I/mL and excellent at 300 mg I/mL. Gastrografin caused bowel distention and poor visualization related to dilution. It also precipitated in the stomach. Iohexol was rapidly absorbed from the peritoneal cavity and excreted by the kidneys, without causing peritonitis. Rat plasma iohexol levels were three times controls in obstructed bowel and 80 times controls if there was mucosal injury without perforation. Rabbit peak plasma levels were 30 times greater following intraperitoneal injection than with gastric gavage. These observations suggest that iohexol may be useful as a gastrointestinal contrast agent. Measuring plasma iohexol levels may be helpful in the evaluation of suspected bowel ischemia or perforation in the clinical setting.

Animals↗

PubMed1992

Comparison of iohexol 300 and diatrizoate meglumine 60 for body CT: image quality, adverse reactions, and aborted/repeated examinations.

Six hundred patients were prospectively randomized and given either diatrizoate meglumine 60 or iohexol 300 during dynamic contrast-enhanced body CT in order to compare image quality, contrast reactions, and the number of aborted studies or studies in which images had to be repeated. Three hundred two patients received iohexol 300, and 298 patients received diatrizoate meglumine 60. Thirty-nine percent (119/302) of the patients given iohexol 300 and 63% (188/298) of the patients given diatrizoate meglumine 60 had at least one adverse reaction thought to be related to contrast material during, or within 24 hr of, the body CT scan. When reactions of discomfort (heat or warmth, flushing, bad taste) were excluded, 16% (48/302) of the patients who received iohexol and 33% (99/298) of the patients who were given diatrizoate meglumine 60 had at least one adverse reaction. The differences in both types of reactions between the two agents were significant (p less than .001). Among scans evaluated for study quality, 71% (214/302) of the iohexol 300 group and 62% (184/298) of the diatrizoate meglumine 60 group had optimal enhancement (p = .02). However, when the optimal and adequate categories were combined, 301 of 302 patients given iohexol 300 and 292 of 298 patients given diatrizoate meglumine 60 had diagnostic-quality studies (no statistical difference). Studies were not terminated nor were images repeated in 97% (292/302) of the patients given iohexol 300 and in 94% (280/298) of those given diatrizoate meglumine 60. The CT study was repeated because of movement during the contrast injection or aborted because of contrast-related reactions in 0.7% of the patients given iohexol 300 and in 3.0% of the patients given diatrizoate meglumine 60. This difference was statistically significant (p = .04). Our results suggest that the difference in image quality, number of adverse reactions, and number of aborted/repeated CT scans performed with iohexol 300 or diatrizoate meglumine 60 are not sufficiently different to warrant conversion to nonionic agents for body CT scans.

Diatrizoate Meglumine↗

PubMed1987

The effect of intrathecal iohexol on visual evoked response latency: a comparison including incidence of headache with iopamidol and metrizamide in myeloradiculography.

Fifty consecutive unselected patients referred for myeloradiculography and examined by the same radiologist, when facilities for measuring the visual evoked response were available, are considered. The effect on the visual evoked response of the examination and the incidence of headache following the use of iohexol as the contrast medium are compared with those after the use of iopamidol and metrizamide reported in a previous study. A total of 400 cases examined with iopamidol and 200 cases examined with iohexol are reviewed with regard to the incidence of headache. Whereas iopamidol and, to a greater extent metrizamide, were found to cause significant lengthening of the visual evoked response latency 20 hours after the radiological examination, iohexol did not. Furthermore there was no significant difference in the 20 hour reading following the use of iohexol compared with the original control group of patients who underwent lumbar puncture alone. There was a lower incidence and severity of headache following the use of iohexol than with iopamidol and a markedly reduced incidence compared with metrizamide. Iohexol is considered less neurotoxic than iopamidol which had previously superceded metrizamide as the contrast medium used for myeloradiculography in the Royal Surrey County Hospital. Volumes of up to 14 ml of iohexol 300 mg I/ml have been used for lumbar radiculography and for total myelography and up to 10 ml for direct lateral cervical puncture. In 350 cases examined to date with iohexol the only serious sequel was a case of chemical meningitis following the lumbar injection of 10 ml of the 300 mg I/ml solution for a cervical examination. The patient made an uneventful recovery.

Clinical Trials as Topic↗

PubMed1990

Sodium addition and/or oxygen saturation of iohexol during normal and reduced perfusion pressure. Effects on contractile force and risk of ventricular fibrillation in the isolated rabbit heart.

The influence on contractile force (CF) and the propensity for ventricular fibrillation (VF) from infusing the non-ionic contrast medium iohexol during normal (75 cm H2O) and reduced perfusion pressure (35 cm H2O) were investigated in the isolated rabbit heart. Both during normal and reduced perfusion pressure iohexol (150 mg I/ml) with oxygen saturation caused a smaller reduction of CF than iohexol without oxygen. During reduced pressure iohexol with sodium addition (28 mM NaCl) caused less depression of CF than iohexol without sodium. The combination of sodium addition and oxygen saturation had the least influence on CF. Iohexol (350 mg I/ml) without sodium had a similar fibrillatory propensity during both normal and reduced pressure. Enriching iohexol with 28 mM NaCl decreased the risk of VF. The decrease was similar during both normal and reduced pressure. The risk of VF from oxygen saturation of iohexol (350 mg I/ml, without sodium) was similar during both normal and reduced pressure. It is concluded that a small addition of sodium and/or oxygen saturation of a non-ionic monomeric contrast medium have beneficial effects on the heart both during normal perfusion pressure and during ischemia.

Animals↗

PubMed1986

Excretory urography with iohexol: evaluation in children.

A multicenter clinical study was conducted using iohexol, a second-generation nonionic contrast medium, for excretory urography performed in 130 children. Doses of iohexol (300 mg iodine/ml) ranged between 150 and 660 mgI/kg (0.5 and 2.2 ml/kg). Iohexol was tolerated well, and no significant adverse reactions occurred. Sixty-five iohexol urograms were evaluated to determine the minimum dose for adequate visualization of the kidneys and collecting systems. A dose greater than 300 mgI/kg (1.0 ml/kg) always resulted in a urogram of diagnostic quality, while visualization was insufficient for diagnosis in 10% of studies done with doses of 150-300 mgI/kg (0.5-1.0 ml/kg). Another 65 iohexol urograms were compared in a blinded manner with a similar number of studies performed using iothalamate meglumine at comparable iodine concentration and dose. Visualization of calyces and pelvoinfundibular structures achieved with iohexol was rated better with statistical significance, but there was no difference in visualization of the renal parenchyma or ureters. Use of iohexol in excretory urography may be advantageous in children who are at greatest risk for an adverse reaction to contrast media or in those most likely to benefit from use of a low osmolality contrast agent.

Adolescent↗

PubMed1991

Comparison of iohexol with barium in gastrointestinal studies of infants and children.

This study evaluates iohexol as a contrast agent in the gastrointestinal tract in children. In the first part of the study, iohexol in concentrations of 180 and 300 mg l/ml was compared in double-blind manner with barium. Sixty-four patients were studied. No significant difference in changes of blood pressure and pulse rate was found between the three groups of patients studied. Diarrhea was significantly more common in the children receiving iohexol than in children receiving barium. The diarrhea was not due to previously identified high-risk factors in the children, nor was it due to concurrent medication. When image quality was assessed in each anatomic region of the gastrointestinal tract, fewer nondiagnostic ratings occurred with barium than with iohexol. With barium, fewer ratings of poor mucosal coating and slightly fewer ratings of suboptimal contrast density occurred. The second part of the study was an open evaluation of iohexol 180 mg l/ml in 18 patients in whom barium was clinically contraindicated. Three of 53 assessments were nondiagnostic. Mucosal coating was poor in 6%, and contrast density was suboptimal in 8% of patients. The results of this study indicate that barium is the preferred contrast agent for routine evaluation of the gastrointestinal tract in children. Good-quality images can be obtained, however, with iohexol in concentrations of 180 or 300 mg l/ml, and iohexol is an excellent contrast agent for evaluation of the gastrointestinal tract in those patients in whom barium is relatively or absolutely contraindicated.

Adolescent↗

PubMed1990

Effects on renal hemodynamics and tubular function of the contrast medium iohexol in renal patients.

Renal function was assessed in 20 (11 female and 9 male, age 21-76 years, mean 53) renal patients with a creatinine clearance 25-145 ml/min, mean 95, to evaluate the effects of iohexol, a non-ionic low-osmolar contrast medium. Intravenous urography was performed in 16 patients and computed body tomography in 4, using a dose of iohexol ranged between 0.6-3.3 (mean 1.17) g/kg b.w. Different parameters of renal function were determined in the week preceding and 1, 3 and 5 days after the administration of iohexol. The principal renal effect of iohexol was an increase of urinary alanine aminopeptidase, gamma-glutamyltransferase, lactate dehydrogenase, alkaline phosphatase and N-acetyl-beta-D-glucosaminidase. The maximum increase of enzymuria was observed on day 1 after the administration of iohexol. In most cases enzymes returned to base-line values within 3 days. No relevant variation of renal hemodynamics (glomerular filtration rate and effective renal plasma flow) was observed after iohexol. In conclusion, iohexol can increase of urinary enzymes, but the effect is rapidly reversible and is not accompanied by a clinically significant impairment of renal hemodynamics.

Acetylglucosaminidase↗

PubMedDate not supplied

Iohexol: summary of North American and European clinical trials in adult lumbar, thoracic, and cervical myelography with a new nonionic contrast medium.

Iohexol, a new water-soluble nonionic contrast medium, was evaluated in clinical trials in Europe and North America for lumbar, thoracic, and cervical myelography using direct C1-2 or lumbar puncture. Iohexol was administered at 180, 240, or 300 mg I/ml to 677 adult patients for visualization of the lumbar subarachnoid space, and to 368 adult patients for evaluation of the cervical area. Compared with metrizamide, use of iohexol resulted in equivalent opacification but significantly reduced patient morbidity (headache, nausea, vomiting, dizziness). No epileptogenic activity was recorded in over 370 patients receiving iohexol. No mental or psycho-organic syndrome manifestations were observed in any of the 1,045 patients receiving iohexol. Adverse reactions occurring after iohexol injection were not related to the concentration or site used or to total dose administered. Iohexol has, thus far, proven superior to metrizamide for myelography.

Adult↗

PubMed1989

Age dependence of renal function: clearance of iohexol and p-amino hippurate in healthy males.

Iohexol, a newly developed non-ionic contrast agent, has been recently documented as a reliable glomerular filtration marker. This study describes the age dependence of the single injection clearance of iohexol in a sample of healthy male volunteers ranging from 21 to 77 years of age. In parallel, renal plasma flow was studied by measuring the total clearance of p-amino hippuric acid administered as a continuous infusion. In subjects older than 50 years a negative correlation to age was found for both p-amino hippuric acid and iohexol clearance, with a reduction of 52 ml/min and 12 ml/min per decade, respectively, whereas no age dependence was found for younger subjects. Correlation between p-amino hippuric acid and iohexol clearances was 0.81. However, the filtration fraction, defined as the ratio of iohexol to p-amino hippuric acid clearance, was higher in the elderly subjects. A consistent discrepancy was found between total and renal clearances of p-amino hippuric acid, indicating significant renal metabolism. Renal clearance of creatinine was poorly correlated to iohexol clearance and did not show any relationship to age.

Adult↗

PubMedDate not supplied

Iohexol cerebral angiography. Multicenter clinical trial.

Ionic contrast media currently used in cerebral angiography frequently cause discomfort due to hyperosmolality. This double-blind, multicenter trial compared two ionic media, meglumine iothalamate and meglumine-Na diatrizoate, with the new nonionic agent, iohexol, in 277 patients undergoing cerebral angiography. Vital signs, cardiovascular changes, and neurologic status were evaluated before, during, and after injection. Patients were observed for adverse reactions for up to 24 hours following studies. Patient discomfort and image quality were evaluated. Visualization was good or excellent with all media studied. No significant physiological differences were observed between the ionic and iohexol groups, but fewer iohexol patients experienced large increases (greater than 20 mmHg) in systolic blood pressure. Iohexol patients experienced significantly less discomfort; ionic patients reported severe discomfort 21/2 times more often. This finding was attributed to iohexol's low osmolality. Iohexol may be indicated particularly for use in selective angiograms where discomfort is a factor and for patients suspected of having blood-brain barrier disruption.

Adult↗

PubMed1988

Urine profiles following intravenous diatrizoate, iohexol, or ioxilan in rats.

The effects of intravenous diatrizoate, iohexol, ioxilan, or saline on albumin, glucose, sodium and the enzymes N-acetyl-beta-D-glucosaminidase (NAG), lactate dehydrogenase (LDH), and L-gamma-glutamyltransferase (GGT) in the urine of 24 normal Wistar rats were followed for seven days. During the first two hours after administration of diatrizoate, all profile components changed markedly; the albumin excretion was significantly greater than following ioxilan and iohexol; glucose, LDH, and GGT excretions were significantly greater than following ioxilan. Iohexol and ioxilan caused a higher excretion of albumin, LDH, and GGT than saline. Iohexol also increased glucose and sodium levels. Glucose and GGT were significantly higher following iohexol than following ioxilan. Both high osmolar and low osmolar contrast media may cause temporary glomerular and tubular damage. Urine profile components are affected most by diatrizoate, less by iohexol, and least by ioxilan.

Animals↗

PubMed1991

A comparison of iohexol and diatrizoate-meglumine in children undergoing cardiac catheterization.

Iohexol (Omnipaque) and meglumine and sodium diatrizoate (Renografin-76) were compared in a double-blind, randomized study for their efficacy, safety, and hemodynamic effects as angiographic contrast agents in children. Forty-four children were randomly allocated to receive either iohexol or diatrizoate as a component of their routine or emergency cardiovascular evaluation. Following age stratification, baseline physiologic parameters were not significantly different between patients receiving either iohexol or diatrizoate. After systemic ventricular injection, iohexol produced significantly less hemodynamic alteration in systemic systolic blood pressure, systemic ventricular end-diastolic pressure, and dP/dt. Less alteration in heart rate and significantly less effect on the QT interval were seen with iohexol. Image quality was comparable, although significantly more patient mobility was associated with diatrizoate-meglumine. This study shows that iohexol, a nonionic contrast medium, causes less hemodynamic disturbance than diatrizoate-meglumine in children. Therefore, its use to be preferred in these potentially high-risk patients.

Adolescent↗

PubMed1991

Pretreatment with steroids before intravenous injection of diatrizoate or iohexol. Effects on urine and serum profiles.

The effects on urine and serum profiles of intravenous injection of diatrizoate, iohexol, or saline were studied in male rats pretreated with steroids or saline. Using urinary albumin, glucose, sodium, and the enzymes lactate dehydrogenase (LDH), gamma-glutamyltransferase (GGT), and N-acetyl-beta-D-glucosaminidase (NAG) as markers of glomerular and tubular function, it was found that diatrizoate caused temporary glomerular and tubular dysfunction; the effect was independent of the kind of pretreatment. Iohexol did not cause increased glomerular permeability in steroid- and saline-pretreated rats. When used following saline, iohexol induced increased excretion of three tubular components, whereas iohexol plus steroids caused increased excretion of all five tubular components. The dysfunctional effect of iohexol plus steroids was less than that of diatrizoate plus steroids. The serum components revealed no abnormalities induced by either contrast media or methylprednisolone. Pretreatment with steroids has no effect on the glomerular or tubular dysfunctional effect of diatrizoate, whereas it worsens the temporary tubular dysfunctional effect of iohexol in rats.

Acetylglucosaminidase↗