Usage and dosage of iodophor injection

General principle For all radiographic contrast agents, only the lowest dose that meets the imaging requirements should be used. A lower dose can reduce the possibility of adverse reactions. The dosage and concentration of iodophor injection should be selected according to the patient's specific conditions, such as age, weight, blood vessel size, blood flow velocity, etc. At the same time, we should consider the development degree and scope required by the expected pathological characteristics, the structure and site to be examined, the influence of the lesion on the patient, and the equipment and technology adopted. It is suggested that the temperature of iodine-containing contrast agent during vascular injection is equal to or close to body temperature. If there are adverse reactions during injection, the injection should be stopped immediately until the reaction subsides. Patients should be fully hydrated before and after injection of iodophor injection. Like other contrast agents, iodophor injection cannot be mixed with other drugs because of possible chemical incompatibility. Sterile operation procedures must be observed when injecting contrast media. If you use disposable instruments, you should pay attention to careful cleaning to prevent detergent residue pollution. The contrast agent must be sucked from the container with sterile syringes and pipetting devices under strict aseptic conditions, and the contrast agent transferred to other infusion systems must be used immediately. Contrast media for injection should be checked for particles and discoloration before use. If the above two situations occur, don't use it again. Iodophor injection is packaged in a single dose, and the unused part should be discarded. General angiography can develop the cardiovascular system by any radiological technique. The administration method of digital subtraction angiography (IA-DSA) has been adjusted, so it is described separately. Cerebral blood flow imaging is the first choice to prompt the following patients: severe arteriosclerosis, severe hypertension, heart failure, the elderly, recent cerebral thrombosis or embolism, migraine, so we should be extra careful when performing cerebral arteriography. This product is generally used for cerebral angiography. The dose of angiography of common carotid artery or vertebral artery in adults is 2- 12ml, and it can be injected repeatedly if necessary. It takes 20-50ml to develop four blood vessels at the same time after aortic arch injection. The total dose t usually does not exceed 200 ml. Peripheral angiography must pulse when injecting artery: patients with thromboangiitis obliterans or severe ischemic disease with upward infection need to be extra careful when performing angiography. This product is recommended for peripheral angiography. Generally, the average adult dose of various peripheral arteriography is: 60ml(20-90ml) for common iliac artery, 40ml( 10-50ml) for femoral artery and 20ml( 15-30ml) for abdominal artery. If necessary, it can be injected repeatedly, and the total dose usually does not exceed 250ml. According to the technique adopted, visceral artery, renal artery and aortography may have the following risks: injury of aorta and adjacent organs, pleural perforation and renal injury (including infarction, acute tubular necrosis with oliguria and anuria). If administered through the waist, it may lead to retroperitoneal hemorrhage, spinal cord injury and transverse myelitis. In the case of slow aortic circulation, aortography can easily lead to muscle spasm. It is reported that serious neurological complications, including paraplegia, occasionally occur in patients with aortic occlusion, femoral artery occlusion, abdominal compression, hypotension, hypertension, spinal anesthesia and injection of pressor drugs. In these patients, the concentration, volume and times of repeated injections of contrast media should be kept to a minimum, repeated injections must be carried out at appropriate intervals, and the positions of patients and catheter heads must be carefully monitored. High-dose contrast agent injected into renal artery from aorta can cause proteinuria, hematuria, creatinine and urea nitrogen to increase, but it is asymptomatic in clinic, and renal function often returns to normal soon. It is recommended to use this product for visceral arteriography, renal arteriography and aortic angiography. The general injection volume of aorta and various visceral arteries is: aorta 45 ml (10-80 ml), abdominal artery 45 ml (12-60 ml), superior mesenteric artery 45 ml (15-60 ml), renal artery or inferior mesenteric artery 9 ml (6-/kloc). The total dose does not exceed 250 ml. The premise of this examination of coronary angiography and left ventricular angiography is the participation of professional medical personnel, ECG monitoring equipment and adequate rescue and cardioversion facilities. During the whole process, patients should be continuously monitored by ECG and vital signs. It is recommended to use this product for coronary angiography and left ventricular angiography. Usually, the single injection dose of coronary angiography and left ventricular angiography is: left coronary artery 8ml(2- 10ml) right coronary artery 6ml( 1- 10ml) left ventricular angiography 40ml(30-50ml) can be repeated if necessary, and the total dose is usually less than 250ml. When a single large dose of contrast agent is injected, such as ventriculography and aortography, it is suggested to wait for a few minutes before injecting the next dose, so that the hemodynamic disorder will subside. The prerequisite for this examination of children's angiocardiography is the participation of professional medical personnel, ECG monitoring equipment and adequate rescue and cardioversion facilities. During the whole process, patients should be monitored continuously for electrocardiogram and vital signs. Some patients have a high risk of adverse angiographic reactions, including: infant asthma, drug and/or allergen sensitivity, congestive heart failure, serum creatinine 15mg/dI or 12 months. This product is recommended. Generally, the single intraventricular injection dose of this product is l25ml/kg body weight (lml/kg-l5ml/kg body weight). For multiple injections, the total dose shall not exceed 5ml/kg, and the total dose shall not exceed 250ml. Attention should be paid to venography when patients suspected of thrombosis, phlebitis, severe ischemic disease, local infection or severe obstruction of venous system are undergoing venography. In order to avoid extravasation during injection, fluoroscopy is recommended. This product is recommended for this operation. Usually the dosage is 50- 100ml, which is increased or decreased according to the situation. After operation, using sodium chloride (USP) or 5% glucose solution to flush the venous system, massaging and raising the lower limbs are also beneficial to the removal of contrast media. CT scanning head scans tumors: Iodophor injection is beneficial to observe the existence and scope of some malignant tumors. For example, glioma includes malignant glioma, astrocytoma, glioblastoma, oligodendroglioma, ganglioma, ependymoma, medulloblastoma, meningioma, neuroblastoma, pineal tumor, pituitary adenoma, craniopharyngioma, germ cell tumor and metastatic tumor. There is no evidence that enhanced CT scanning actually helps to detect retrobulbar space, poorly differentiated or invasive gliomas. When the lesion is calcified, the possibility of increase is low, and the enhanced imaging of the tumor may be reduced or not enhanced at all after treatment. After injection of contrast agent, the cerebellar projection can be enhanced, which may lead to false positive results. Non-tumor condition: Enhanced imaging with iodophor injection is helpful for the diagnosis of non-tumor lesions. The recent cerebral infarction can be better developed by using contrast agent, but some infarcts may also be blurred. Within 1-4 weeks after onset, about 60 cases were injected with iodine-containing contrast agent, and the effect was enhanced. Injection of human contrast media can also promote the development of active infectious diseases. Both arteriovenous malformation and aneurysm can show contrast enhancement. The enhancement of these vascular diseases depends on the iodine content in the circulating blood pool. There is little contrast enhancement between hematoma and cerebral parenchymal hemorrhage. However, the use of contrast media is helpful to rule out the possibility of arteriovenous malformation for clinically unexplained cerebral parenchymal thrombosis. Adults: The general dose of this product is 50- 150ml, and it is usually scanned immediately after intravenous injection. The dosage of this product usually does not exceed 150ml. Children: The recommended dosage of this product is 1 ml/kg to 3 ml/kg body weight. Enhanced CT scanning with iodophor injection is beneficial to the discovery and diagnosis of liver, pancreas, kidney, aorta, mediastinum, pelvic cavity, abdominal cavity and retroperitoneal space lesions. Contrast enhancement produced by iodophor injection is more reliable than plain scan in the diagnosis of lesions. In other cases, the use of contrast agent can obtain images of lesions (such as tumor spread) that cannot be obtained by CT alone or help to determine suspicious lesions (such as pancreatic cysts) obtained by CT plain scan. Adults: This product can be injected by injection, rapid drip or two ways. The usual dosage is summarized as follows: 25-75ml of this product is injected into pellets, and 50- 150ml is dripped. The dosage of this product usually does not exceed 150ml. Children: The recommended dose of this product is 1 ml/kg to 3 ml/kg body weight, and the general dose is 2 ml/kg body weight. Intravenous Digital Subtraction Angiography Intravenous Digital Subtraction Angiography (IV DSA) is a dynamic imaging of arterial system by using image enhancement, iodine signal enhancement and digital processing of image data after intravenous injection of X-ray contrast agent containing iodine. Subtract the image before injection of contrast agent from the image of artery passing through the contrast agent for the first time, and get the enhanced artery image without bone cheese and soft tissue. IV DSA is most commonly used to examine the heart, including coronary artery bypass grafting, pulmonary artery, brachiocephalic artery, aortic arch, abdominal aorta and its main branches, uncinate artery and limb artery. IV DSA does not require special patient preparation, but it is recommended to drink plenty of water before examination. In addition to the above general preventive measures, the risks caused by intravenous DSA include injection into the blood vessel wall, formation of dissection and tissue extravasation. It is suggested to inject a small amount of contrast agent under fluoroscopy to ensure the correct position of catheter head and the appropriate vein thickness during peripheral angiography, which can reduce the potential danger The patient's activities, including breathing and swallowing, will lead to wrong recording, which will lead to the decline of image quality and affect the diagnosis. This product can be injected into the superior and inferior vena cava or right atrium from the center, or injected into the human body from the periphery through the appropriate brachial plexus vein. For central injection, the catheter can be inserted into the basilic vein outside the anterior cubital fossa or into the femoral vein from the leg, and further flow to the distal segment of the corresponding vena cava. During peripheral injection, the catheter can be inserted into the arm vein of appropriate size in the anterior cubital fossa. To prevent extravasation during peripheral injection, a catheter with a length of about 2Ocm should be used. Depending on the scanning site, the dose of each injection is usually 30-50 ml. Can be repeated if necessary. The total dose shall not exceed 250 ml. Injection speed varies with catheter placement and blood vessel size. The central injection speed is usually 10-30d/s, and the peripheral injection speed is usually12-20ml/s. Because the contrast agent will stay in the arm vein for a period of time, it is recommended to flush the vein with an appropriate volume (20-25ml) of sodium chloride injection or 5% glucose aqueous solution immediately after injection. Intravenous voiding urography suggests that this product be used for routine and high-dose voiding urography. Dehydration before examination is dangerous and may lead to acute renal failure. Adults: The usual dose of routine excretory urography is 15 ~ 2 oml/kg. When it is considered that the expected effect can't be obtained by using conventional dose (such as elderly patients or patients with renal insufficiency), high dose contrast agent can be used to obtain better contrast effect. But the maximum dose shall not exceed 150ml. Children: 0.5ml/kg to 3ml/kg body weight dose t of this product can make urography meet the diagnostic requirements. The general dose for children is 1 ml/kg to15ml/kg. The dosage of infants and children should be adjusted according to the proportion of age and weight. The total dose given should not exceed 3 ml/kg.