Abstract
THE articles by Barrett et al.1 and Steinberg et al.2 in this issue of the Journal address the important problem of deciding how to choose between low-osmolality and high-osmolality intravascular radiographic contrast agents. Should low-osmolality agents be used universally, or only in selected patients? On what basis should this decision be made? If low-osmolality agents are used selectively, what criteria should be applied to identify those who should receive them?Conventional agents that have osmolalities of 2000 mOsm per kilogram have been in use since the 1950s. The newer agents, which have the same radiopacity, have osmolalities of 600 to . . .

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