title: Validation of a Novel Monitoring System to Measure Contrast Volume Use During Invasive Angiography.
abstract: BACKGROUND
  Multiple studies have demonstrated the relationship between contrast volume (CV) and the risk of acute kidney injury (AKI). Quantification of total CV is often estimated and therefore may be inaccurate. We describe validation of a novel contrast monitoring system (CMS) (Osprey Medical), which is designed to detect and display injection by injection and total CV use on a monitor system in real time.
  
  
  METHODS
  Thirty patients undergoing a coronary or peripheral angiogram were included. Ten patients underwent procedures using the CMS only and 20 underwent procedures using both the CMS and the AVERT Plus contrast modulation system (Osprey Medical). Total CV used during these cases was measured using direct measurement via a graduated cylinder (CVDM). This was compared with the CMS-reported CV and with the operator's assessment of CV (CVPE) used during the case. Intraclass correlation coefficient (ICC) and Pearson correlation coefficient (PCC) were used for analysis and the results displayed using Bland-Altman plots.
  
  
  RESULTS
  Twenty-one cases were diagnostic and 9 were interventional. The ICC/PCC (confidence interval [CI]) for the comparison of CVDM to CMS and CVPE were 0.96/0.97 [CI, 0.94-0.99] and 0.89/0.90 [CI, 0.80-0.95], respectively, with a P=.01 for difference between the correlations. The average absolute difference between the CVDM and CMS readout and the CVPE was 12.0 ± 13.7 mL and 22.8 ± 15.3 mL, respectively; P=.01.
  
  
  CONCLUSIONS
  The CMS was accurate when compared with the direct measurement of CV used. This accuracy was superior to physician estimation of CV.
authors.affiliation: Department of Medicine, Division of Cardiology, University of Texas Health Science Center, 7703 Floyd Curl Drive, San Antonio, TX 78229-3990 USA. prasada@uthscsa.edu.
authors.forename: Anand
authors.initials: A
authors.lastname: Prasad
authors.forename: Irma
authors.initials: I
authors.lastname: Scholler
authors.forename: Daniel
authors.initials: D
authors.lastname: Levin
authors.forename: Gus
authors.initials: G
authors.lastname: Banda
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Mullin
authors.forename: Steven R
authors.initials: SR
authors.lastname: Bailey
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced / Q000175:diagnosis / Q000517:prevention & control; D000368:Aged; D000792:Angiography / Q000009:adverse effects / Q000379:methods; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects; D061827:Dimensional Measurement Accuracy; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D016503:Drug Delivery Systems / Q000379:methods*; D016903:Drug Monitoring / Q000295:instrumentation / Q000379:methods / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000592:standards; D015203:Reproducibility of Results; D013223:Statistics as Topic; D014652:Vascular Diseases / Q000175:diagnosis*
chemical_list: D003287:Contrast Media