When do you hydrate the pt

ALL pts who will receive IV contrast should be prehydrated, in order to PREVENT any CIN (Contrast-induced nephropathy).

Check out the articles below (obtained by doing a Google search using the words "contrast prehydration prevent nephropathy"):


http://www.apia.org.au/pdf/May06_Con...ephropathy.pdf

http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

http://www.medscape.com/viewarticle/494060_6


(who is betting, and what are the differing opinions??) --- D

Cool.

Keep in mind IV contrast is also a diuretic so it is important to hydrate before and after the injection. In a patient without renal insuficency I am comfortable with PO hydration rather than IV.
Jeremy

We recently have been checking the GFR (glomerular filtration rate) in addition to the creatinine. If your lab is not reporting this you can go to www.nkdep.nih.gov and use the calculator. If the GFR is <60 the Rads will decide on before or after. At present they all want something different, but we are working on protocols.

Creatinine over 1.6 we administer 1/2 of the contrast dose and hydrate afterwards.

We do use Visipaque (iodixanol) for creat >1.5 AND eGFR <60. All other exams we use Omnipaque 350 (iohexol). This is for Cath Lab use.

IR uses Visipaque exclusively.