Literature DB >> 26427700

Protective effect against repeat adverse reactions to iodinated contrast medium: Premedication vs. changing the contrast medium.

Shoko Abe1, Hozumi Fukuda2, Kimiko Tobe2, Kenji Ibukuro2.   

Abstract

OBJECTIVES: The purpose of this study was to assess the protective effect of premedication and changing contrast media (CM) against repeat adverse reactions (ARs) to iodinated CM.
METHODS: Between January 2006 and September 2014, 771 cases with previous ARs to CM were administered CM. The same CM that had caused ARs previously was administered to 491 cases (220 without premedication [defined as the control group], and 271 with premedication [the premedication alone group]). A different CM from the previous CM was given to 280 cases (58 without premedication [the changing CM alone group], and 222 with premedication [the premedication and changing CM group]).
RESULTS: The control group had 61 repeat ARs (27.7%). The premedication alone group had 47 ARs (17.3%, p<0.01). The changing CM alone group had 3 ARs (5.2%, p<0.001). Three ARs (7.9%) were observed in 38 cases changing from one to another low-osmolar nonionic CM. Twenty cases with previous ARs to the high-osmolar CM and to the low-osmolar ionic CM showed no ARs. The premedication and changing CM group had 6 ARs (2.7%, p<0.001).
CONCLUSION: Premedication prior to contrast for patients with previous ARs may be protective, however, changing CM was more effective. KEY POINTS: • In patients with previous adverse reactions, changing contrast media is recommended. • Premedication is unnecessary against previous reactions to high-osmolar or ionic CM. • Changing from one to another low-osmolar non-ionic CM may be effective.

Entities:  

Keywords:  Hypersensitivity; Iodinated contrast media; Premedication; Repeat adverse reaction; Safety

Mesh:

Substances:

Year:  2015        PMID: 26427700     DOI: 10.1007/s00330-015-4028-1

Source DB:  PubMed          Journal:  Eur Radiol        ISSN: 0938-7994            Impact factor:   5.315


  21 in total

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3.  Trends in adverse events after IV administration of contrast media.

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5.  Premedication of patients for prior urticarial reaction to iodinated contrast medium.

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8.  Basophil activation in the diagnosis of life-threatening hypersensitivity reaction to iodinated contrast media: a case report.

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3.  Re-exposure to low osmolar iodinated contrast media in patients with prior moderate-to-severe hypersensitivity reactions: A multicentre retrospective cohort study.

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4.  A Case of Alveolar Haemorrhage Induced by Iodinated Contrast Medium Use.

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6.  To crack a nut with a sledgehammer: premedication in a patient with a history of mild symptoms following the injection of a contrast agent.

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Review 7.  Diagnosis and Prevention of Hypersensitivity Reactions to Iodinated Contrast Media.

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8.  Contrast Medium Hypersensitivity: A Large Italian Study with Long-Term Follow-Up.

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10.  Management of Adverse Reactions to Iodinated Contrast Media for Computed Tomography in Korean Referral Hospitals: A Survey Investigation.

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