Contrast media are used to enhance visualization of a variety of anatomical structures
(Isaac, 2012). Hydration is considered the gold standard in preventing Contrast-Induced
Nephropathy. Fluids dilute contrast medium, thereby decreasing direct nephrotoxic effects of inflammation and necrosis on renal cells (Isaac, 2012). In patients with renal disease, does the nursing assessment of patients receiving sodium bicarbonate infusion versus normal sodium infusion yield more complications of Contrast-Induced Nephropathy (CIN)? CIN can be defined as an increase in baseline creatinine level by 25% or greater within 48 hours after a procedure that requires contrast material (Isaac, 2012). Creatinine is the end-product of muscle breakdown …show more content…
Not all of the doctors choose the sodium bicarbonate protocol. Several cardiologists prefer instead to hydrate the patient with normal saline at 150 milliliters/hour for one hour prior to the procedure and reduce to 100 milliliters/hour for six hours post procedure. This has piqued my interest to see if sodium bicarbonate is better than a normal saline to prevent CIN. The sample population of the study consists of 294 consecutively enrolled elderly patients over the age of 60 with renal impairment who had undergone vascular procedures and used iodixanol, an iso-osmolar non-ionic contrast media exclusively (Isaac, 2012). Patients were divided equally into two groups, “A” and “B”. Group A patients were placed on a normal saline hydration at 1 ml/kg/hr. beginning 3 hours before the procedure and continuing 6-8 hours after administration of the contrast. Group B patients were placed on a sodium bicarbonate at 3 ml/kg beginning one hour prior to procedure followed by a decreased infusion rate at 1 ml/kg/hour until
6 hours after contrast injection. A physician investigator monitored the creatinine, potassium, and venous blood gases of each patient at 24 and 48 hours after completion of hydration
(Isaac, 2012). Hydration is considered the gold standard in preventing Contrast-Induced
Nephropathy. Fluids dilute contrast medium, thereby decreasing direct nephrotoxic effects of inflammation and necrosis on renal cells (Isaac, 2012). In patients with renal disease, does the nursing assessment of patients receiving sodium bicarbonate infusion versus normal sodium infusion yield more complications of Contrast-Induced Nephropathy (CIN)? CIN can be defined as an increase in baseline creatinine level by 25% or greater within 48 hours after a procedure that requires contrast material (Isaac, 2012). Creatinine is the end-product of muscle breakdown …show more content…
Not all of the doctors choose the sodium bicarbonate protocol. Several cardiologists prefer instead to hydrate the patient with normal saline at 150 milliliters/hour for one hour prior to the procedure and reduce to 100 milliliters/hour for six hours post procedure. This has piqued my interest to see if sodium bicarbonate is better than a normal saline to prevent CIN. The sample population of the study consists of 294 consecutively enrolled elderly patients over the age of 60 with renal impairment who had undergone vascular procedures and used iodixanol, an iso-osmolar non-ionic contrast media exclusively (Isaac, 2012). Patients were divided equally into two groups, “A” and “B”. Group A patients were placed on a normal saline hydration at 1 ml/kg/hr. beginning 3 hours before the procedure and continuing 6-8 hours after administration of the contrast. Group B patients were placed on a sodium bicarbonate at 3 ml/kg beginning one hour prior to procedure followed by a decreased infusion rate at 1 ml/kg/hour until
6 hours after contrast injection. A physician investigator monitored the creatinine, potassium, and venous blood gases of each patient at 24 and 48 hours after completion of hydration