Grant of contrast stuff is normally rather safe. However, injection of any sort will convey little unsafe hazard, including hurt to the nervousnesss, vass artery ( arteria ) or venas ( vena ) , redness ( infection ) or an allergic reaction to the injected stuffs.
Injured blood vass will do escape of contrast stuff into the environing musculus tissue / tissues ( Extravasation ) . This hazard was estimated in 0.04 % to 1.3 % .
Other hazards / complications of the injection of contrast stuff particularly allergic reaction, and may include:
aˆ? Occasionally, mild reactions such as the organic structure feels a warm ( flowers ) , sneezing, sneezing, itchiness of ruddy musca volitanss and swelling ( urtications ) , purging and concern. A small dizzy with the feeling like purging that will vanish in a few proceedingss.
aˆ? For the basic I contrast stuff is injected to press gustatory sensation in oral cavity, bad breath out of kinds and organic structure feels warm in the lower venters ( pelvic ) and on the dorsum of the pharynx.
aˆ? Rarely a stronger reaction such as asthma ( Asthma ) , daze ( daze ) and ictuss ( paroxysms ) . Emergency supplies are available for events This rare.
aˆ? Death in highly rare instances, approximately 1 in. Injection of 250,000 to 400,000 ( 0.0004 % ) .
aˆ? Although less than 1 % injected dose absorbed into the ASI ( Air Susu Ibu ) , suckling is recommended that patients stopped breast eating ( breast milk ) for 24 hours after injection and discard chest milk after injection of contrast.
Radiographic contrast stuff
Contrast stuffs are compounds used to better visual image ( visibleness ) on the internal constructions of a medical diagnostic imagination. Contrast stuff used in the X-ray imagination to better X-ray fading ( positive contrast stuff ) that will be discussed here or greater cut down the power of X-ray fading ( negative contrast stuff with air base or gas ) . In add-on to the contrast stuff is besides used in analyzing MRI ( Magnetic Resonance Imaging ) , but this method is non based on X raies, but vary magnetic belongingss of the H karyon absorbs the contrast stuff. Materials Such contrast MRI with Gadolinium is.
Contrast stuff, Ba sulfate, a white pulverization that was indissoluble. This pulverization is assorted with H2O and some extra constituents to do the mixture contrast. This stuff is by and large merely used in the digestive piece of land, normally ingested or given as an clyster. Upon scrutiny, this stuff will come out of the organic structure along with the faces.
Iodine contrast stuff
Iodine contrast stuff can be bound to organic compounds ( non-ionic ) or a ionic compounds. Ionic stuffs was foremost made and is still widely used to depend on the intended review. Ionic stuffs have side consequence profile is worse. Organic compounds have side effects because there are fewer molecules dissociates the constituents. Many of the side effects caused by the hyper osmolar solution which is injected, which these substances lead to more iodine atoms per molecule. The more I, so coerce X-ray fading additions. There are many different molecules. Media I based contrast to H2O soluble and non harmful to the organic structure. Contrast stuffs are widely sold as a solution of clear, colorless liquid. Concentration is normally expressed in milligram I / ml. Modern teriodinasi contrast stuff can be used in about all parts of the organic structure. Most of them used endovenous, but for different intents can besides be used in intra-arterial, intra-theca ( spinal ) and intra-abdominally – about the full organic structure pit or a possible infinite.
Based on the phases of its development, form and chemical composing of the contrast media:
a. Before 1950
In this period, all ionic contrast media is iodine, which in agreement. There is a chemical ion. Ions composing the contrast media consist of:
cathode and anode.
B. Mid Year 1950
Get downing mid-year 1950 established the molecular footing of the usage of benzoic
each molecule binds three atoms of I. At this phase the development of shared
1 ) . Ionic Contrast Material
Ions composing contrast media cathode that consist ( +ve charge ) and anions ( -ve charge ) ions. Cathode edge to the acerb extremist ( -COO- ) concatenation pealing C1 benzine. Cathode besides gives the features of contrast media, in which each type give different features to each other. There are several sorts of cathode. The usage of contrast media, including:
a ) . Sodium ( Natrium )
The nature of the Na in contrast medium was reduced viscousness ( viscousness ) , and fewer anaphylactic reactions caused by cut downing substances emergence histamine that cause allergic reactions. On the other manus is more sodium corrosive of cells endothelium and parenchyma of certain variety meats, doing it more toxic of other substances.
B ) . Meglumine ( NMG, N-Methylglucamine )
Meglumine have toxic belongingss are smaller than Na, but meglumine diuretic consequence ( cut downing the concentration of I in the piss ) . In the acid type and concentration of meglumine less the same cause addition in blood force per unit area, bradycardia, and paroxysms than Na.
degree Celsius ) . Ethanolamine
These substances have belongingss that are non owned by Na meglumine maupub, is non hold toxic belongingss and has a low viscousness, but this substance vasodilatation cause strong plenty. In add-on to the above stuffs are sometimes besides used cathode of Ca ( Ca ) and Mg ( Mg ) . To obtain the coveted belongingss of contrast media in radiology scrutiny normally done some combination of several types of cathode in a types of contrast media:
( 1 ) . Ionic Contrast Material Monomer
Monomer ionic contrast stuffs is a signifier of ionic contrast stuff that has
one ring in a molecule of benzoic acid.
( 2 ) . Ionic Contrast Material dimmer
Ionic contrast media is holding two rings of benzoic acid in one molecule. One illustration of the form and chemical composing of this type of contrast stuff
is Oxalate ( Hexabrix ) which is the first demerit ionic contrast media made.
2 ) . Non-ionic contrast stuffs.
During the chemical composing of non-ionic contrast media have non found the being of ionic bonds between the atoms composing the molecule. If the ionic contrast media, there are two compiler molecular atoms ( cathions and anions ) in the non-ionic contrast stuff. There is merely one atom that has a molecular concept its ain features.
( 1 ) . Non-ionic contrast stuff Monomer
Contrast stuff was derived from an ionic monomer contrast media, which is the
replacing the carboxyl group by a extremist group that is non-ionic amide ( -CONH2 ) .
( 2 ) . Ingredients Non-ionic dimeric contrast
Formation of the chemical construction of contrast stuff through the procedure of replacing the group carboxyl dimmer ionic contrast media every bit good as by groups of non-ionic groups, which in terminal of a sisntesa green goods I to particle ratio contrast media 6: 1.
The concentration of active molecules that provide the solution osmotic force per unit area, so
supply the capableness of a dissolver ( H2O ) through a membrane. To put with milliosmol per liter ( osmolarity ) or milliosmol per kg H2O ( H2O ) in the 37oC ( osmolality ) .
Osmolality was non influenced by atom size, but its value depends ;
The entire atom concentration and I. Ionic contrast stuff has a figure of atoms greater than non-ionic contrast stuff because of the ionic contrast media are two atoms ( cations and anions ) to two times higher osmolality.
OSMOLALITY ( m 0sm/Kg ) = mgI/ml. K.G
Iodine contrast stuffs that modern medical specialties are safe ; reactions dangerous could go on, but non common. The chief side effects are anaphylactic reactions and nephropathy.
1. Reaction-Reaction Anaphylactic
Anaphylactic reactions are rare, but can happen as a response to the contrast stuff is injected or given via unwritten and rectal pyelografi and even decline. Symptoms are similar to anaphylactic reactions, but non caused by IgE mediated immune response. Patients who have a history of reaction to contrast, at high hazard for sing reactions anaphylactic. Anaphylactic reactions runing from urtication and can rub, until bronchospasma and facial and laryngeal clyster. For instances of moderate and urticaria itchiness. Benadryl ( Diphenhydramine ) through the oral cavity or IV ( endovenous ) can be given. For reactions are more terrible, such bronchospasma and cervix or facial clyster can be given hypodermic or epinephrine IV or albuterol inhalator, add Diphenhydramine may necessitate. If respiration is affected, the air passage should be released.
2. Nephropathy caused by Contrast Medium
Contrast media kidney disease could be caused by both the addition in blood keratinise degree greater than 25 % . There are three factors associated with increased hazard of nephropathy is influenced by the contrast medium, nephritic upsets are diabetes, and intravascular volume is reduced. Osmolality contrast stuff is believed to play an of import function in nephropathy. Ideally, contrast stuff should iso-osmolar of blood. Iodized contrast stuff that modern typically non Attic, ionic types of old-type common cause harmful effects over and non used once more. To minimise the hazard of contrast medium nephropathy as a consequence, the assorted actions could be done, all of which have been analyzed in a meta-analysis are:
1. The dosage of contrast media should be tried every bit low as possible, although
still able to carry on reviews added.
2. Non ionic contrast stuff
3. And non-ionic contrast media iso-osmolar. One of controlled tests
Random discovered that a substance iso-osmolar non-ionic contrast is better compared to non-ionic contrast media of low-osmolar.
4. Hydration endovenous fluids with a salt solution.
5. Intravenous unstable hydration with saline solution plus Na hydrogen carbonate.
Consequence of hydrogen carbonate renoprotektif alkalinises be caused by piss, which creates an environment that is more susceptible to the formation of harmful free groups. 6. N-asetilcystein ( NAC ) .NAC, 600 milligram usage twice a twenty-four hours by orally, the twenty-four hours before during the process if the discharge is less than the estimated keratinize clearance 60 milliliter / min ( 1.00 milliliter / sec ) . A randomised controlled test found that the higher doses of NAC to help the ( 74 % of decrease hazard ) coronary angioplasty received by patient with a higher volume of contrast. Some recent research shows that the N-asetilcystein protecting kidneys from the toxic consequence of contrast stuffs.This consequence is non equally distributed, some research workers ( eg Hoffman et al. , 2004 ) have claimed that this consequence caused by intervention with creatinine research lab trial itself. This is supported by the deficiency of correlativity between rates of creatinine and cystatin C content.Other pharmacologic agents, like Dopastat, Osmitrol, Lasix, , aminophylline, Elixophyllin and atrial natriuretic peptide already tried, but no good consequence or even have a harmful. Kemotoksik reactions in patients who have thyroid upsets frequently experience a reaction after an review kemotoksik with contrast stuff. Actually, the edge I atom into the compound of contrast stuff did non give a large influence. It is merely sensitive to the little independent iodide ions were found in the contrast stuff. Increase consumption of iodide is why tirotoksikosis. The part of sea-food and other allergic reactions should be emphasized here that the allegations about the “ allergy ” of seafood, which is frequently based more on myth compared to the fact, that is non a contraindication to the usage of contrast stuff beriodum. A correlativity between the rate of I in seafood and seafood allergic reaction as a consequence are portion of the medical field. Although the rate of I in seafood is higher than in non-marine nutrients, but consume the last of these exceed the first and there is no grounds to propose that the iodine content of seafood related to the reactions of sea-food. Data suggest seafood allergic reactions due to increased hazard of a reaction that is mediated by the sum of contrast stuff about the same as allergic to the fruit or the same as the causes of asthma. In other words, more than 85 % of patients who suffer nutrient allergic reactions, the sea will non hold unsafe reactions to iodise contrast. Last, there is no grounds to propose that the tegument reactions that are harmful to the antiseptic-containing topical I antiseptic ( such as betadin, povidin ) a batch to make with giving IV contrast stuff.