Comparison of carbon dioxide and iodinated contrast for cavography prior to inferior vena cava filter placement.
BACKGROUND
The use of iodinated contrast in the critically ill trauma patient has been associated with the development of acute renal failure. The low incidence of nephrotoxicity associated with carbon dioxide (CO(2)) makes it an ideal contrast agent for cavography. However, the use of CO(2) has been limited, because reportedly it underestimates the diameter of the inferior vena cava (IVC).


METHODS
During a 6-month period (January 2000 through June 2000), 25 adult trauma patients required IVC filter placement. Bedside cavagrams using CO(2) followed by iodinated contrast were employed to determine the diameter of the IVC and the anatomy of the renal veins.


RESULTS
Using CO(2) injection for cavography, we were able to determine the diameter of the IVC and the anatomy of the renal veins in all patients. Furthermore, when CO(2) cavography was compared with the results obtained with iodinated contrast, the difference in diameter of the IVC was within 1 mm.


CONCLUSIONS
Based on these data, it was determined that CO(2) cavagrams accurately reflect the diameter of the IVC and the anatomy of the renal veins. Additionally, CO(2) cavagrams can be safely performed in the intensive care unit during bedside placement of IVC filters.
Holtzman
Robert B
RB
Division of Trauma and Critical Care, Memorial Regional Hospital, 3501 Johnson St., Hollywood, FL 33021, USA.
Lottenberg
Lawrence
L
Bass
Thomas
T
Saridakis
Angeleke
A
Bennett
Vicki J
VJ
Carrillo
Eddy H
EH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001837:Body Weights and Measures / Q000379:methods; D002245:Carbon Dioxide; D003287:Contrast Media / Q000494:pharmacology*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007479:Iopamidol; D008297:Male; D008875:Middle Aged; D010690:Phlebography / Q000379:methods*; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000209:etiology / Q000517:prevention & control; D012082:Renal Veins / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D016306:Vena Cava Filters; D014682:Vena Cava, Inferior / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D020246:Venous Thrombosis / Q000150:complications / Q000000981:diagnostic imaging*; D014947:Wounds and Injuries / Q000150:complications / Q000000981:diagnostic imaging
D003287:Contrast Media; D002245:Carbon Dioxide; D007479:Iopamidol