Review Article
The Choice of the Iodinated Radiographic Contrast Media to Prevent Contrast-Induced Nephropathy
Table 1
Iodinated contrast media used in clinical practice.
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Ionic and nonionic contrast media may be monomeric or dimeric; 3 iodine atoms are delivered with each benzene ring of a contrast medium: if a contrast molecule contains only 1 benzene ring, it is called a monomer; if it contains 2 benzene rings, it is called a dimer. In a solution, ionic contrast media break up into their anion and cation components, thereby increasing osmolality, while nonionic contrast media do not break up in solution. Nonionic dimers are the ideal contrast media as they deliver the most iodine with the least effect on osmolality. The osmolality of contrast media is compared with the osmolality of plasma. HOCM = high osmotic contrast media have the highest osmolality, that is, 5–8 times the osmolality of plasma. LOCM = low osmotic contrast media have an osmolality still higher than plasma, that is, 2-3 times the osmolality of plasma. IOCM = isoosmotic contrast media have the same osmolality as plasma. Cps: viscosity in centipoise. Most data of viscosity are from [118]. (Reproduced and modified from [8], with permission) |