Advertisement

Adverse reactions to intravenous contrast media: an unexpected discrepancy between inpatient and outpatient cohorts

      Abstract

      Adverse reaction rates to computed tomography (CT) and magnetic resonance imaging (MRI) contrast agents are well published. However, there is no literature regarding systems-based changes to improve contrast reaction management. As part of ongoing quality improvement monitoring at our institution, contrast reaction events were reviewed. Contrast reactions for CT and MRI were captured at lower rates for the inpatient setting compared to outpatient by an order of a magnitude. The documented inpatient events were more likely to be severe in nature. Given this discrepancy, focus is being placed upon identifying potential barriers to capturing and appropriately managing inpatient contrast reactions.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Clinical Imaging
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Dillman JR
        • Strouse PJ
        • Ellis J
        • Cohan RH
        • Jan SC
        Incidence and severity of acute allergic-like reactions to IV nonionic iodinated contrast material in children.
        Am J Roentgenol. 2007; 188: 1643-1647
        • Dillman JR
        • Ellis JH
        • Cohan RH
        • Strouse PJ
        • Jan SC
        Frequency and severity of acute alleric-like reactions to gadolinium-containing IV contrast media in children and adults.
        Am J Roentgenol. 2007; 189: 1533-1538
        • Hunt CH
        • Hartman RP
        • Hesley GK
        Frequency and severity of adverse effects of iodinated and gadolinium contrast materials: retrospective review of 456,930 doses.
        Am J Roentgenol. 2009; 193: 1124-1127
        • Murphy KJ
        • Brunberg JA
        • Cohan RH
        Adverse reactions to gadolinium contrast media: a review of 36 cases.
        Am J Roentgenol. 1996; 167: 847-849
        • Bruder O
        • Schneider S
        • Nothnagel D
        • Pilz G
        • Lombardi AS
        • Sinha A
        • et al.
        Acute adverse reactions to gadolinium-based contrast agents in CMR: multicenter experience with 17,767 patients from the EuroCMR registry.
        J Am Coll Cardiol Img. 2011; 4: 1171-1176
        • Li A
        • Wong CS
        • Lee CM
        • Au Yeung MC
        Acute adverse reactions to magnetic resonance contrast media—gadolinium chelates.
        Br J Radiol. 2006; 79: 368-371
        • Abujedeh HH
        • Kosaraju VK
        • Kaewlal R
        Acute adverse reactions to gadopentate dimeglumine and gadobenate dimeglumine: experience with 32,659 injections.
        Am J Roentgenol. 2010; 194: 430-434
        • Bellin MF
        • Van Der Molen AJ
        Extracellular gadolinium-based contrast media: an overview.
        Eur J Radiol. 2008; 66: 160-167
        • Loh S
        • Bagheri S
        • Katzberg RW
        • Fung MA
        • Li CS
        Delayed adverse reaction to contrast-enhance CT: a prospective single-center study comparison to control group without enhancement.
        Radiology. 2010; 255: 764-771
        • Schild HH
        • Kuhl CK
        • Hübner-Steiner U
        • Böhm I
        • Speck U
        Adverse events after unenhanced and monomeric and dimeric contrast-enhanced CT: a prospective randomized controlled trial.
        Radiology. 2006; 240: 56-64
        • Cochran ST
        • Bomyea K
        • Sayre JW
        Trends in adverse events after IV administration of contrast media.
        Am J Roentgenol. 2001; 176: 1385-1388
        • Freed KS
        • Leder RA
        • Alexander C
        • DeLong DM
        • Kilewer MA
        Breakthrough adverse reactions to low-osmolar contrast media after steroid premedication.
        Am J Roentgenol. 2001; 176: 1389-1392
        • Wang CL
        • Cohan RH
        • Ellis JH
        • Caolli EM
        • Wang G
        • Francis IR
        Frequency, outcome, and appropriateness of treatment of nonionic iodinated contrast media reactions.
        Am J Roentgenol. 2008; 191: 409-415
        • Prince M
        • Zhang H
        • Zou Z
        • Staron RB
        • Brill PW
        Incidence of immediate gadolinium contrast media reactions.
        Am J Roentgenol. 2011; 2: 138-143
        • Jung JW
        • Kang HR
        • Kim H
        • Lee W
        • Min KU
        • Han MH
        Immediate hypersensitivity reaction to gadolinium-based MR contrast media.
        Radiology. 2012; 264: 414-422
        • Murphy KP
        • Szopinski KT
        • Cohan RH
        • Mermillod B
        • Ellis JH
        Occurrence of adverse reactions to gadolinium-based contrast material and management of patients at increased risk: a survey of the American Society of Neuroradiology fellowship directors.
        Acad Radiol. 1999; 6: 656-664
        • Forsting M
        • Palkowitsch P
        Prevalence of acute adverse reactions to gadobutrol—a highly concentrated macrocyclic gadolinium chelate: review of 14,299 patients from observational trials.
        Eur J Radiol. 2010; 74: 186-192