Reactions to intravenous contrast media. Part I: Severe and fatal cardiovascular reactions in a canine dehydration model.

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Abstract
Investigations into the nature of severe and fatal reactions to contrast media are severely limited by their unpredictable occurrence in the clinical setting and the absence of suitable laboratory models. A canine dehydration model was studied. I.v. administration of 2 ml/kg of 76% sodium methylglucamine diatrizoate resulted in vomiting, shock, inappropriate slowing of the heart rate and death. ECG findings indicated suppression of sino-atrial node automaticity, a decrease in the rate of atrioventricular conduction and depression of myocardial contractility. These results suggest 2 possible mechanisms: enhanced vagal tone as the result of stimulation of the vasomotor center of the medulla or accentuation of direct contrast-induced myocardial toxicity.