When do you use Visipaque-320 and when Omnipaque-350?

Our standard agent is Omnipaque-350 but for high risk patients we use an iso-osmolar agent which is Visipaque-320.

A list of increased risk patient follows but we also use Visipaque-320 for all PE studies, cardiac CTA studies, and all pediatric patients.

Patient-related Risk Factors for CIN

Established

• – Pre-existing renal impairment with diabetes
• – Pre-existing renal impairment without diabetes
• – Dehydration
• – Congestive heart failure
• – Multiple myeloma
• – Advanced age
• – Administration of nephrotoxic drugs

Newly identified

• – Hypertension
• – Metabolic syndrome
• CIN, contrast-induced nephropathy 

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  "Intravenous contrast material application in high risk patients is unlikely to be associated with permanent adverse outcomes. SCr levels after contrast material administration are lower in iodixanol than iopromide groups."
  
  Iso-osmolality versus Low Osmolality Iodinated Contrast Medium at Intravenous Contrast-enhanced CT: Effect on Kidney Function.
• In patients with impaired renal function, SCr levels are less likely to increase when iso-osmolality iodixanol is used, as compared with low osmolality iopromide."
  
  Iso-osmolality versus Low Osmolality Iodinated Contrast Medium at Intravenous Contrast-enhanced CT: Effect on Kidney Function.