Ventilatory effects of radiographic contrast media

Respiratory adverse reactions have been reported with the use of contrast media. This study investigates the effects of different radiographic contrast media (RCM) on ventilation and blood gases. Tidal volume and respiratory rate of male Wistar rats anaesthetised with Inactin (100 mg kg(-1) intraperitoneally), were measured continuously by integration of tracheal airflow. Contrast media (diatrizoate 370, ioxaglate 320 and iopromide 300) or mannitol controls matched for volume, pH and osmolarity (4 ml kg(-1)) were administered via a jugular cannula (n greater than or equal to 36 per group). Carotid artery blood was sampled at 2, 7, 12, 17, 25 and 30 min post-injection for PaO2, PaCO2 and pH. Systemic blood pressure was monitored from the same cannula. No significant reduction was observed in minute ventilation (tidal volume x respiratory rate per minute) with any of the contrast media. All contrast media and control solutions produced a fall in PaO2 within 4 min; returning to basal levels at 10 min (diatrizoate 35.6% (p<0.05), ioxaglate 15.2% (p<0.02), iopromide 16.2% (p<0.01); controls: 17.3% (p<0.01), 13.5% (p<0.02) and 12.0% (NS), respectively). The fall in PaO2 induced by diatrizoate was significantly (p<0.05) larger in comparison to the other groups. Ioxaglate, iopromide and their mannitol controls induced a comparable fall in PaO2. There was a concurrent rise in PaCO2 and fall in pH that reached significance for diatrizoate (p<0.01). The change's in blood gases with RCM administration cannot be explained by changes in ventilation and may be due to an effect on pulmonary perfusion.