Contrast Dosing Protocols
Weight-Based Dosing
Traditional fixed dosing (e.g., 100mL for everyone) is outdated.Lean Body Weight (LBW) is often the best predictor for contrast enhancement because contrast does not distribute well into adipose tissue.
- Liver Protocol: Typically 500-600 mgI/kg
- CTA (Angiography): High flow rate is critical (4-5 mL/s)
- Routine Chest/Abdo: can often be optimized to < 70-80mL for smaller patients.
Minimizing Nephropathy (CIN)
For patients with compromised renal function (eGFR < 30), minimizing volume is crucial.
Hydration is Key: The most effective preventative measure is IV volume expansion (e.g., 0.9% Saline) pre- and post-procedure.
Pediatric Considerations
Children are more sensitive to radiation and contrast load. Dosing must be strictly according to weight.
General Rule:
1.5 - 2.0 mL per kg of body weight (using 300 mgI/mL concentration), up to a standard adult max.
*Use the lowest possible volume to achieve diagnostic quality.