PROPOSAL Proposal: The Prevention of Contrast-Induced Nephropathy During a Cardiac Catheterization Word Count: 500 (2 pages) I. Introduction This isa proposal based on the piece to be fully written about how to prevent contrast-induced nephropathy during a cardiac catheterization. There are three sections to be discussed: the actual procedure of the cardiac catheterization; what nephropathy is; and how to best prevent contrast-induced neuropathy during the cardiac catheterization. II. The Procedure of Cardiac Catheterization The purpose of a cardiac catheterization is essentially to find out if one has disease in one’s coronary arteries, if there are valvular problems present, if there are abnormal pressures in the heart, or if there are other heart defects. If disease?is found in the coronary arteries, this test can determine the size ?and location. The results from a cardiac catheterization can help the ?physician know how to best treat the patient. ?The cardiac catheterization is performed in a cardiac cath lab suite. Once the patient enters the suite, the patient is put on a flat X-ray table. The patient is put on an electrocardiogram machine, which continuously records the electrical activity of the patient’s heart during the procedure. After prepping the patient, a local anesthetic is injected into the skin at the insertion site—whether it is the ?femoral artery, brachial artery, or the radial artery. Then a sheath, a thin?flexible tube, is inserted in the artery. Once arterial access
is ?obtained, a catheter can be passed into the blood vessel and moved into?various positions in the heart's vessels and chambers while the ?physician can obtain an angiographic picture or pictures of the heart arteries?and chambers of the heart. III. What is Nephropathy? Contrast-induced nephropathy is a 25 percent or more increase in the?serum creatinine after a radiographic examination using a contrast ?agent. This is a serious problem. Nephropathy is?considered to be a common complication in angiographic procedures. This is an important use for clinicians, physicians, including pharmacists who ?provide services for these patients, who have renal insufficiencies. Contrast-induced nephropathy is one of the most serious adverse events associated with the use of contrast media. It is the third leading cause of hospital-acquired acute renal failure. It has been reported ?that individuals who develop contrast-induced nephropathy have ?increased morbidity, higher rates of mortality, lengthy hospital?stays, and poor long-term outcomes. Researchers indicate that chances ?of developing contrast-induced nephropathy can be reduced by employing appropriate prevention strategies like those outlined in the following section. IV. How Nephropathy Can Be Prevented During a Cardiac Catheterization There are several ways that the risks of nephropathy can be reduced during a cardiac catheterization. Various ?actions can be taken such as: adequate pre-procedure hydration; having the patient maintain a low-protein diet prior to the procedure; avoiding ionic contrast; having a minimal amount of contrast usage; having minimal views to delineate the anatomy; reviewing all the?drugs for the potential renal-compromised patients; manage the diabetics patients carefully; and always have the nephrologists nearby on a standby mode. ? V. Conclusion In order to prevent contrast-induced nephropathy during a cardiac catheterization, it is important to: 1) know what a cardiac catheterization is; 2) know what is nephropathy; and 3) know the techniques which would best help prevent contrast-induced nephropathy during a cardiac catheterization session.