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Diatrizoate Levels in Cerebrospinal Fluid Following Intravenous Administration Role of Fluid Production Rate

The central nervous system (CNS) may be highly susceptible to the toxic effects of conventional contrast media (CM). The current study quantifies levels of diatrizoate in canine cerebrospinal fluid (CSF) following intravenous administration and examines how these levels change as CSF production rate is reduced. Cerebro-spinal fluid was collected continuously from the cisterna magna of anesthetized dogs before and after the administration of diatrizoate (1 mL/kg bolus followed by a 12.5 μl/kg/minute maintenance infusion, IV). The influence of CSF production rate on CSF diatrizoate levels was examined by injecting acetazolamide (30 me/kg, IV). Diatrizoate levels in CSF were quantified by a high performance liquid chromatography (HPLC) method. Baseline CSF production was 81.5 μl/minute and dropped to 37.4 μl/minute following diatizoate and to 29.5 μl/minute following acetazolamide. The concentration of distrizoate in CSF averaged 166 μg/mL and increased significantly to 379 μg/mL following acetazolamide with no change in serum coincentration (1.3 mg/mL). These experimental results suggests that appreciable quantities of intravenously administrated diatrizoate may enter the CNS, and that these quantities may increase significantly with reduced CSF productioin. This may help to explain CSF enhancement and certain CNS toxicity after the intravenous administration of CM.