Impact Of Different Intravenous Fluids On Blood Glucose Levels In Nondiabetic Patients Undergoing Elective Major Noncardiac Surgeries
Go to: Intravenous (IV) fluids are an integral part of perioperative management. Intraoperative hyperglycemia is associated with poor clinical outcomes in patients undergoing major surgeries even in nondiabetics. This study was conducted to observe the effect of different maintenance fluid regimens on intraoperative blood glucose levels in nondiabetic patients undergoing major surgeries under general anesthesia. One hundred nondiabetic patients of either sex were divided randomly into two Groups I and II of 50 each undergoing elective major surgeries of more than 90 min duration under general anesthesia. Both groups were given calculated dosage of IV fluids accordingly 4-2-1 formula while Group I was given Ringer lactate (RL) and Group II was given 0.45% dextrose normal saline and potassium chloride 20 mmol/L. Changes in vital parameters, % oxygen saturation, and urine output were monitored at regular intervals. Capillary blood glucose (CBG) was measured half-hourly until end of surgery. If CBG level was more than 150 mg%, then calculated dose of human insulin (CBG/100) was given as IV bolus dose. Statistical analysis was done using SPSS 22.0 software (IBM Corporation, Armonk, New York, USA), paired t-test and Chi-square test. A significant increase of CBG level and was observed during intraoperative and immediate postoperative period (P < 0.001) in Group II. RL solution is probably the alternative choice of IV fluid for perioperative maintenance and can be used as replacement fluid in nondiabetic patients undergoing major surgeries. Keywords: Double-blind method, human, hyperglycemia, insulin, regular, Ringer's lactate Baseline clinical profile Continue reading >>
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Metformin And Contrast Media: Where Is The Conflict?
Abstract Intravascular administration of iodinated contrast media to patients who are receiving metformin, an oral antidiabetic agent, can result in lactic acidosis. However, this rare complication occurs only if the contrast medium causes renal failure, and the patient continues to take metformin in the presence of renal failure. Because metformin is excreted primarily by the kidneys, continued intake of metformin after the onset of renal failure results in a toxic accumulation of this drug and subsequent lactic acidosis. To avoid this complication, metformin must be withheld after the administration of the contrast agent for 48 hours, during which the contrast-induced renal failure becomes clinically apparent. If renal function is normal at 48 hours, the metformin can be restarted. There is no scientific justification for withholding metformin for 48 hours before administration of the contrast medium, as currently recommended in the package insert. The authors review the pharmacology of metformin and present a departmental policy for managing patients with diabetes who receive metformin and who require intravascular administration of iodinated contrast media. Continue reading >>
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Positron Emission Tomography (pet Scan)
Positron emission tomography (PET or PET scan) is a specialized radiology procedure used to examine various body tissues to identify certain conditions. PET may also be used to follow the progress of the treatment of certain conditions. While PET is most commonly used in the fields of neurology, oncology, and cardiology, applications in other fields are currently being studied. PET is a type of nuclear medicine procedure. This means that a small amount of a radioactive substance, called a radionuclide (radiopharmaceutical or radiotracer), is used to perform the procedure. Specifically, PET studies evaluate the metabolism of a particular organ or tissue, so that information about the physiology (functionality) and anatomy (structure) of the organ or tissue is evaluated, as well as its biochemical properties. Thus, PET may detect biochemical changes in an organ or tissue that can identify the onset of a disease process before anatomical changes related to the disease can be seen with other imaging processes, such as computed tomography (CT scan) or magnetic resonance imaging (MRI) . PET is most often used by oncologists (doctors specializing in cancer treatment), neurologists and neurosurgeons (doctors specializing in treatment and surgery of the brain and nervous system), and cardiologists (doctors specializing in the treatment of the heart). However, as advances in PET technologies continue, this procedure is beginning to be used more widely in other areas. PET is also being used in conjunction with other diagnostic tests such as computed tomography (CAT scan) to provide more definitive information about malignant (cancerous) tumors and other lesions. The combination of PET and CT shows particular promise in the diagnosis and treatment ofmany types ofcancer. Until rece Continue reading >>
Metformin And Contrast Medium
To decrease your chance of developing lactic acidosis, you should temporarily stop taking metformin if you are going to undergo a procedure that uses a contrast medium. Because the contrast medium causes temporary damage to the kidneys (and because the kidneys remove metformin), contrast medium can greatly increase the level of metformin in the blood. An Overview of Metformin and Contrast Medium Metformin (Glucophage®) is a prescription medication licensed to treat type 2 diabetes. Due to an increased risk of a dangerous side effect called lactic acidosis, metformin should be temporarily stopped in people undergoing procedures involving contrast medium. What Is Contrast Medium? Contrast medium, also known as contrast dye, is used for certain radiology procedures. It is usually taken by mouth or injected, and helps to produce clear radiology images. Some common procedures involving contrast medium include: Certain computed tomography (CT) scans Cholangiography (a radiology procedure looking at the gallbladder or bile ducts) Intravenous urogram (used to look at the bladder or kidneys). Metformin and Contrast Dye Risks Contrast medium can be damaging to the kidneys. Usually, this damage is temporary and corrects itself quickly. However, because the kidneys remove metformin, contrast medium can greatly increase the level of metformin in the blood because damaged kidneys are not as effective at removing metformin from the body. High levels of metformin in the blood increase the risk of lactic acidosis (see Metformin and Lactic Acidosis). Because lactic acidosis is so dangerous, metformin should be temporarily stopped for procedures involving contrast medium. Our free DiscountRx savings card can help you and your family save money on your prescriptions. This card is accepted Continue reading >>
"blood Sugar Levels After Mri W/dye": Diabetes Community - Support Group
Post my content anonymously (without my username) Put this on my watchlist and alert me by email to new posts I have MRI's taken of the brain with and without contrast (dye) every 2 years to track a benign tumor. There is always something on the permission sheet that says if a certain test on the panel from regular yearly checkups is high, to ask for a different dye because my kidneys are not working as well as they should, and they can't filter out that dye within a few hours. That would account for your rise. I think the test was the GFR which needs to be above 60. Ask your doctor. I understand the supposed purpose of the contrast dye but I've never understood the necessity.After having TIA's, I had an MRI & the doctor suggested using contrast dye which I refused, since I wasn't comfortable with it & didn't see the necessity, so it was done without dye. After completion, I had an opportunity to view & discuss the results with the technician. Not only were the pictures clear & detailed, but I asked him if they would have been clearer with dye. He said "Not likely." I asked him why dye was ever used, he just shrugged.I also had retina pictures taken a few months ago. I know that sometimes dye is used, but again, I have clear, sharp pictures with no dye.I don't know if the contrast dye is harmful in other ways (besides blood sugar) but IMO, if there is no necessity, why use it? Continue reading >>
Mri - Wake Radiology
Wake Radiology is proud to have received the highest accreditations possible from the American College of Radiology (ACR). Wake Radiology is the clear choice for radiology services. + By nearly3-to-1, Triangle residents prefer Wake Radiology over any other imaging group.* + 90%of patients would recommend Wake Radiology to a friend (far exceeding national averages).** *Public Policy Polling.**The Ask Your Patient Survey, 2014. Magnetic Resonance Imaging (MRI) is an amazing technology that creates images for a radiologist to interpret from the water in your body. Giant magnets allow your body to receive radio waves and echo them back. A computer uses the information within the echoes that bounce back from your body to create images. The images created are unique to a patient, depicting his or her anatomy and any disease that may be present. The whole process is safe and painless. Some patients are so comfortable inside the magnet that they actually fall asleep while this advanced imaging takes place. The radiologist may administer Valium, a relaxing medication, for patients experiencing anxiety or claustrophobia so that the examination will be a more acceptable experience. Family members or friends who can drive the patient home after the exam must accompany patients who receive intravenous Valium. These patients are advised not to drive or operate dangerous equipment for the remainder of the day. The powerful magnet inside of the MRI machine is shown suspending a wrench in mid air. Even though this powerful force is present, humans cannot feel or sense it.ARE THERE ANY RISKS? Magnetic resonance imaging is very safe. There are no health risks associated with the magnetic field or the radio waves used by the machine. However, some special circumstances limit the use of a Continue reading >>
Why Is Diabetes Mellitus A Risk Factor For Contrast-induced Nephropathy?
Why Is Diabetes Mellitus a Risk Factor for Contrast-Induced Nephropathy? Samuel N. Heyman ,1,* Christian Rosenberger ,2 Seymour Rosen ,3 and Mogher Khamaisi 4 1Department of Medicine, Hadassah Hospital, Mt. Scopus and the Hebrew University Medical School, P.O. Box 24035, Jerusalem 91240, Israel 1Department of Medicine, Hadassah Hospital, Mt. Scopus and the Hebrew University Medical School, P.O. Box 24035, Jerusalem 91240, Israel 2Department of Nephrology, Charit Campus Mitte, Berlin 10115, Germany 3Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA 02215, USA 4Joslin Diabetes Center, Harvard Medical School, Boston, MA 02215, USA Received 2013 Sep 5; Accepted 2013 Oct 24. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This article has been cited by other articles in PMC. Contrast-induced nephropathy (CIN) remains a leading cause of iatrogenic acute kidney injury, as the usage of contrast media for imaging and intravascular intervention keeps expanding. Diabetes is an important predisposing factor for CIN, particularly in patients with renal functional impairment. Renal hypoxia, combined with the generation of reactive oxygen species, plays a central role in the pathogenesis of CIN, and the diabetic kidney is particularly susceptible to intensified hypoxic and oxidative stress following the administration of contrast media. The pathophysiology of this vulnerability is complex and involves various mechanisms, including a priori enhanced tubular transport activity, oxygen consumption, and the generation of reactive oxygen species. The regulation of vascular t Continue reading >>
Pet/ct Cancer Imaging: Cancers Eat A Lot Of Sugar
PET/CT Cancer Imaging: Cancers Eat a lot of Sugar There are many different ways to detect and diagnose cancer. PET imaging is one way to accomplish this. For PET imaging, patients are injected with a small amount of a radioactively marked sugar which, once in the body, reach those organs and tissues that consume a lot of sugar. Tumors consume up to 30 times more sugar then normal tissue. Since the injected sugar is radioactive we can detect its location in the body with a scanner, the PET scanner. The scan then provides us with the following information. Is it cancer? What organs are involved? Has the cancer spread? Did the treatment work? These are questions that the oncologist and the patient and family wonder and hope for reliable and valid answers. One decade ago work began that resulted in what is now called the clinical PET/CT and it is the most exciting and novel imaging tool in oncology today. This tool has dramatically changed how these important questions are addressed. At UCLA over 7000 patients have been studied with the new technology and there is a diagnostic advantage in about 15% of patients with cancer over the previous PET scan alone. As a result more than 2000 PET/CT scanners have been installed worldwide. This presentation helps patients and their family members to understand how imaging techniques are an integral part of comprehensive cancer care. PET/CT imaging plays a vital role in determining stage, and effectiveness of treatments and there is clinical evidence that it is superior to PET or CT alone. Several types of cancer will be used to illustrate how PET/CT is used in diseases such as breast, lung cancer and lymphoma and sarcoma. Johannes Czernin, MD, Professor, Vice Chairman Molecular and Medical Pharmacology, Director of Nuclear Medicine a Continue reading >>
Contrast Dye And The Kidneys
Diagnostic tests such as MRIs, CT scans and angiograms are routinely used because they provide important information about many diseases or injuries and can help in diagnosis and treatment. In many cases, the use of a contrast dye is necessary to enhance these tests, but sometimes these dyes can either lead to kidney problems, or cause problems in patients with kidney disease. There are two rare but serious disorders associated with contrast dyes and the kidneys: contrast induced nephropathy (CIN) and nephrogenic systemic fibrosis (NSF). What is Contrast Induced Nephropathy (CIN)? CIN is a rare disorder and occurs when kidney problems are caused by the use of certain contrast dyes. In most cases contrast dyes used in tests, such as CT (computerized tomography) and angiograms, have no reported problems. About 2 percent of people receiving dyes can develop CIN. However, the risk for CIN can increase for people with diabetes, a history of heart and blood diseases, and chronic kidney disease (CKD) . For example, the risk of CIN in people with advanced CKD (glomerular filtration rate ( GFR ) below 30 mL/min/1.73m2), increases to 30 to 40 percent. The risk of CIN in people with both CKD and diabetes is 20 to 50 percent. CIN is associated with a sharp decrease in kidney function over a period of 48-72 hours. The symptoms can be similar to those of kidney disease, which include feeling more tired, poor appetite, swelling in the feet and ankles, puffiness around the eyes, or dry and itchy skin. In many cases, CIN is reversible and people can recover. However, in some cases, CIN can lead to more serious kidney problems and possible heart and blood vessel problems. What is Nephrogenic Systemic Fibrosis (NSF)? NSF is a rare but serious disease affecting skin and other organs that Continue reading >>
F A C T S H E E T F O R P A T I E N T S A N D F A M I L I E S
Intravenous (IV) Contrast Material What is IV contrast material, and why is it used? Contrast material — or just “contrast†— is a clear liquid that highlights certain parts of your body on imaging tests. Although bones show up well on X-rays and other imaging tests, other organs — such as the kidneys, blood vessels, or brain — are not as easy to see. Because contrast shows up well, it also highlights whatever organ it enters. Many diagnostic radiology tests use contrast, injected using an IV in your wrist or arm. Once it is in a vein, it passes through your blood to highlight the organ being tested. Contrast material can make an imaging test much more effective in identifying a problem or disease. Is contrast material safe? Generally, contrast is extremely safe. But as with any medication, in very rare cases it can cause a severe reaction if you have allergies or certain medical conditions. Your healthcare providers will take precautions to minimize these risks. How do I prepare for a test using contrast material? • Talk to your healthcare providers. Before a test that uses contrast, tell your doctor or the radiology technician if: – You have ever had an allergic reaction to contrast or any medications – You have diabetes, kidney disease, asthma, cancer, or high blood pressure – You are being treated with chemotherapy or antibiotics, or have ever had dialysis If you have any of these factors, your healthcare provider may do a blood test ahead of time and may change how the contrast is used. • Temporarily stop taking certain medications. If you are taking any of the medications below, your healthcare provider will probably tell you to stop taking them: – Pain relievers known as NSAIDs, such as Continue reading >>
Iodine-containing Contrast Medium
18-20 week screening pregnancy ultrasound Find information about a clinical radiology procedure or test: What is Iodine-containing contrast medium? Iodine-containing contrast medium (ICCM), sometimes called contrast or contrast medium, is a chemical substance used in medical X-ray imaging. When injected into the body, ICCM shows what is happening inside the hollow parts of the body (like blood vessels, the stomach, bowel or even the fluid around the spinal cord) on X-ray images or pictures. When injected into a blood vessel, which can be either an artery or a vein, it not only shows the inside of the blood vessel, but it can give information about how the organs supplied by that blood vessel are working. Good examples of this are the kidneys, brain and lungs. It is important to note that ICCM does not produce radiation: it is a chemical substance that harmlessly interacts with X-rays. Why do I need Iodine-containing contrast medium? The radiologist (a specialist doctor) who carries out and interprets your medical imaging procedure or test will read what your doctor has written on your radiology referral. The referral tells the radiologist what your doctor thinks might be wrong and what your doctor wants to know from the test or procedure. This information enables the radiologist to decide if the use of ICCM will provide the necessary images to help them give your doctor the answer. Types of tests that nearly always use ICCM include angiograms/angiography (which are X-rays of blood vessels), arthrography (which is an X-ray of the inside of a joint (like the shoulder)) and myelography (which involves injection of contrast medium into the fluid around the spinal cord). Some, but not all, computed tomography (CT) scans require you to have ICCM either by drinking it or by i Continue reading >>
Contrast Agent Used In Cat Scan
D.D. Family T1 Since 2006, Omnipod Since 2007 Anyone had experience with the effects of the contrast stuff they use for doing abdominal CAT scans ? i have not found out whats in it yet, but wondered if its likely to do crazy things to my BG Ok did some more research. oral contrast used for CT is Gastrografin - mixture of various things including several barium salts. I think the main issue here for non-pumpers would be the requirement to not eat for several hours. Wonder what flavor its going to be.... Last edited by hhinma; 6/17/08 at 06:32 PM. That's an interesting and excellent question. Please do let us know if/how it does effect your bg if you don't get an answer. I also wonder what the stuff you have to ingest for things like colonoscopy and other x-ray tests does to diabetics. I assume and hope the doctor requesting the tests takes the fact that you are diabetic and on a pump into consideration. But yeah, what is in there?? Moderator Type1 - Minimed 640G - Enlite CGM Hi Hhimna, I can't answer your question and looking at your profile I am guessing you are not on metformin... but thought I would bring this up anyway to play it safe. When having dyes & contrast in a medical procedure the metformin must be stopped before hand as it is dangerous to have these procedures done while on met. Like Karen has mentioned, make sure everyone knows that you are diabetic & what meds you are on. D.D. Family T1 41 years, paradigm 522 began 3/08 I have had two contrast MRI's. No appreciable change to bs was noticed. However, for those that have kidney impairment, the dye does stress the kidneys. Many of the MRI's and catscans can be performed without the dye, so be sure to discuss with your MD whether use of the dye is absolutely necessary. I hope the results of your scans turn o Continue reading >>
Abdominal Ct Scan With Contrast: Purpose, Risks, And More
A CT (computed tomography) scan , which is also called a CAT scan, is a type of specialized X-ray. The scan can show cross-sectional images of a specific area of the body. With a CT scan, the machine circles the body and sends the images to a computer, where theyre viewed by a technician. An abdominal CT scan helps your doctor see the organs, blood vessels, and bones in your abdominal cavity . The multiple images provided give your doctor many different views of your body. Keep reading to learn why your doctor may order an abdominal CT scan, how to prepare for your procedure, and any possible risks and complications. Abdominal CT scans are used when a doctor suspects that something might be wrong in the abdominal area but cant find enough information through a physical exam or lab tests. Some of the reasons your doctor may want you to have an abdominal CT scan include: You may have heard of other imaging exams and wonder why your doctor chose a CT scan over other options. Your doctor may choose a CT scan over an MRI (magnetic resonance imaging) because a CT scan is faster than an MRI. Plus, if youre uncomfortable in small spaces, a CT scan would likely be a better choice. MRIs requires you to be inside an enclosed space while loud noises occur all around you. In addition, an MRI is more expensive than a CT scan. Your doctor may choose a CT scan over an X-ray because it provides more detail than an X-ray does. A CT scanner moves around your body and takes pictures from many different angles. An X-ray take pictures from one angle only. So, a CT scan is able to provide more information than an X-ray can. Your doctor will probably ask you to fast (not eat) for 2 to 4 hours before the scan. You may be asked to stop taking certain medications before your test. You may want t Continue reading >>
About Your Pet-ct With Fdg Tracer
An arrowing pointing forward, usually indicating forward movement, or the ability the share something via social media. An icon showing an uppercase letter "X", indicating that this will close the current element. This information will help you prepare for your positron emission tomography (PET) computed tomography (CT) scan with fluorodeoxyglucose (FDG) tracer at Memorial Sloan Kettering (MSK). A PET-CT scan is an imaging procedure thats used to: See how the tissues and organs in your body are working. Find and diagnose many disorders, such as cancer. Most PET scans are done to study your bodys use of glucose (a type of sugar). This is because cancer cells take in glucose faster than normal tissue. Because you get glucose from food and drinks, its important that you follow the dietary guidelines listed in the The Day of Your PET-CT section. Youll have a low dose CT scan done at the same time as your PET. CT scans take a fast series of x-ray pictures. The x-ray pictures are combined with your PET scan to create pictures of the soft tissues and bones in the area that was scanned. You may also be scheduled for a diagnostic CT at the same time as your PET-CT. If youre also having a diagnostic CT scan, ask your nurse for the resource Computed Tomography (CT) Scan . Before your PET-CT, youll get a radioactive medication with glucose called a tracer through an intravenous (IV) line in your arm. This is done to show differences between healthy tissue and diseased tissue. Your PET-CT will use FDG as the tracer. FDG is taken up by your cells and doesnt stay in your body long. You may need to have contrast before your scan. Contrast is a special dye used to make it easier for your doctor to see differences in your internal organs. There are different types of contrast used for i Continue reading >>
Pet/ct Fdg Scan For Patients With Diabetes
DOWNLOADABLE PDF: English | Chinese | Russian | Spanish This handout gives special instructions for patients with diabetes who are having a PET/CT FDG scan at UW Medical Center, Harborview Medical Center, or Seattle Cancer Care Alliance. Your doctor has ordered an exam for you called a PET/CT FDG scan. Please ask for the handout called “PET/CT FDG Scan” if you do not already have it. PET stands for positron emission tomography. CT stands for computed tomography. FDG stands for 2-Deoxy-2-[18F]fluoro-D-Glucose. This exam uses Fluorine-18 FDG, a radioactive tracer that acts like glucose in the body. The tracer helps us see how much energy your cells are using. We measure this with a FDG PET/CT scan. A PET/CT camera takes 2 types of pictures: The PET scan shows where the radioactive tracer has collected in your body. The CT scan provides pictures of your body structures. Together, the PET and CT images help your doctor see changes in your cells. How to Prepare People with diabetes have trouble processing glucose. This means you need to follow special instructions for your scan. Closely follow all instructions in this handout. This will help keep your blood sugar under control and give us the clearest results from this exam. Call your diabetes care provider 2 weeks before your scan to talk about the best way to prepare for your scan. Review the instructions in this handout with this provider. Do not exercise for 48 hours before your scan appointment. Starting 12 hours before your scan, do not take any dextrose medicines by total parenteral nutrition (TPN) or intravenous (IV) line. Starting 12 hours before your appointment time, you cannot eat or drink. You may only drink plain water during this 12-hour fast. Your scan will be early Continue reading >>
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