Potential toxicity from nickel contamination of intravenous fluids.

N ickel contam ination of intravenous fluids warrants concern, owing to three specific toxic effects o f Ni2+: (a) cardiac toxic ity , especially increased coronary artery resistance, (b ) oxytocic action on th e u terus, and (c) allergic reactions, since nickel is a common allergen. In ad­ dition, high concentrations of nickel in in trav en o u s flu ids cou ld evoke n o n ­ specific toxic responses, such as nausea, vom iting, headache, and palp ita tions. Physicians should be especially cogni­ sant o f po ten tial cardiac toxicity from nickel in intravenous fluids that are ad­ m inistered to patients w ith acute myocar­ dial infarction. Most experim ental studies of toxic ef­ fects of nickel on the heart have been conducted at high concentrations of Ni2+ that would be unlikely to occur in clinical situations. However, recent experim ents by Rubanyi and coworkers1,10,18-23 have dem onstrated adverse cardiac effects of Ni2+ at dosages and concentrations that seem re levan t to m edical practice. In isolated, perfused rat hearts, addition of N i2+ (60 fig p e r L) to th e p e rfu s io n m edium significantly increased coronary