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papa
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Joined: 02 Oct 2007
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Location: The State of Confusion
PostPosted: Fri Jan 04, 2008 4:10 pm    Post subject: eGFR and amounts of contrast Reply with quote

ok, me being anal retentive....... Laughing

i've seen all the eGFR calculators online. one of the places i work at the nurses start all the IV's, screen the patients, and when they bring back the paperwork for me to scan the patients, they've written down how much contrast the patient can recieve.

WHAT IS THAT FORMULA!!!

sorry, i've just been beating my head against the wall for about a week now.....

now my head hurts.....

i think i need a CT


papa Rolling Eyes
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Mr. Green papa RT(R)(CT) Mr. Green
Delusional Radiology
never meddle in the affairs of a dragon, for you are crunchy, and taste good with ketchup

papa
Moderator


Joined: 02 Oct 2007
Posts: 297
Location: The State of Confusion
PostPosted: Fri Jan 04, 2008 4:18 pm    Post subject: Reply with quote

wasn't there a comercial some time ago where this evil villian was trying to steal the secret formula for this cereal that the comercial was for and there were these kids, hungry kids, who just wanted to eat their damn cereal, when this guy keeps interupting their well ballanced breakfast of the sugary cereal, orange juice, toast, strawberries and cocaine, which is all part of a well ballanced diet, especially when you drown your fruit loops in jack, maybe even a little irish cream, or maybe that was the secret ingrediant that this evil villian was looking for when all he really had to do was go to his local grocery store and pick up a mallet to bash his own head in to get the same effect......what was the name of that cereal?
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Mr. Green papa RT(R)(CT) Mr. Green
Delusional Radiology
never meddle in the affairs of a dragon, for you are crunchy, and taste good with ketchup

lilstevie



Joined: 31 Dec 2007
Posts: 5
Location: Greenville, MI
PostPosted: Fri Jan 04, 2008 6:22 pm    Post subject: Reply with quote

Haven't heard of anyone doing this for CT yet. all I could find was this.

www.urosource.com/uploads/tx_ahflashinnews/18_Urolithiasis.swf

look at the bottom of page 9.

Here is another interesting one that i found: http://www.auntminnie.com/articles/archive/75000/79000/79318.asp

Or you could just ask your nurse...

Do you guys pretreat with NAC if the patient is at risk?
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papa
Moderator


Joined: 02 Oct 2007
Posts: 297
Location: The State of Confusion
PostPosted: Mon Jan 07, 2008 10:24 am    Post subject: Reply with quote

ok, i found the formula, but no idea where it came from. i found this little memo when i worked saturday:

Quote:

CONTRAST DOSAGES
With all Creatinine values, [name withheld] routinely now gives and estimated GFR, calculated from age, weight and sex adjusted estimates, the following pertains:

Normal GFR = 100cc/min

Standard dose in a healthy patient -
for CT: 1cc/lb up to 150 cc max
for MRI: 0.13 cc/lb, up to 20 cc standard dose (but 40 cc for MRA)

The dose is adjusted proportional to GFR and weight. This takes into account diabetes and hypertension, one kidney, and age, etc.

The dose will be proportional to the GFR, so if the GFR = 57, 57/100 = 60%, then the maximum dose will be: 0.6 times that patient's dose in cc/lb, for 150 lb man that is 0.6 x 150 = 90cc of contrast or 0.6 x 20 = 12cc of Gadolinium.

Exceptions:
1. No CT contrast if GFR is below 30 cc/min
2. Above age 80, Gadolinium is ok, but CT contrast, only with the Radiologist's consult.
3. For GFR 30 to 50 cc, use IV hydration
4. For dialysis patients there is really no limit on the CT dose. For MRI, Gadolinium is usually preferred, but must be given only after informed consent for Nephrogenic Fibrosing Dermopathy.
5. Intrinsic renal disease, GN, ISN, proteinuria, untreated Multiple Myeloma, Waldenstorm's, etc. - No CT contrast.
6. Sickle cell (HbSS) avoid Gad.

any thoughts? i mean, it seems like a good idea, i just wish i knew where this little memo came from, and if this applies to all forms of contrast (visipaque included)

papa
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Mr. Green papa RT(R)(CT) Mr. Green
Delusional Radiology
never meddle in the affairs of a dragon, for you are crunchy, and taste good with ketchup

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