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Everything you need to know about Computed Tomography (CT) & CT Scanning


Reactions and Complications

Extravasations

question1. How often do contrast reactions occur to IV contrast? Are there patients at increased risk?
question2. Although most iodinated contrast reactions are typically mild, what is the long term sequelae to the patient who gets a reaction?
question3. Are there specific patients or risk factors that make it more likely to get a contrast reaction?
question4. Will faster injection rates (5 cc/sec vs. 1 cc/sec) result in an increased incidence of contrast reactions?
question5. What are the categories of contrast reactions?
question6. Death is one of the potential complications of IV contrast. How often does this occur?
question7. What are the risks of IV contrast in terms of renal failure (CIN)? How often does CIN occur? How we prevent CIN?
question8. Who can not get IV contrast material?

Allergic Reactions

question1. Part 1: Can a patient get a rash from IV contrast? Can it occur 24-36 hours post CT study?

Part 2: How do you treat the rash?

question2. Is it possible for a patient to get a delayed reaction to IV contrast?
question3. What if a patient is allergic to IV contrast material?
question4. Part 1: What patients are allergic to IV contrast? Part 2: Can we premedicate these patients and if yes what is our premedication protocol?
question5. Our patient needs the study now. What else can we do?
question6. The patient is allergic to shellfish or crabs. Can they get a IV contrast?

Extravasation

question1. What is contrast extravasation and how often does it occur?
question2. How do you prevent contrast extravasation?
question3. Part 1: How do we treat contrast extravasation when it happens? Part 2: Is cold compresses the rule or hot compresses?
question4. What if extravasation does occur? How often are there severe complications?
questionThe good news is that with most contrast extravasations prompt treatment prevents most complications. The literature recently has a few publications that address this issue.

"Extravasation of nonionic iodinated contrast medium results only rarely in moderate or severe adverse effects, and these usually occur only when large volumes of contrast medium are involved."

Frequency, Management, and Outcome of Extravasation of Nonionic Iodinated Contrast Medium in 69,657 Intravenous Injections
Wang CL et al.
Radiology 2007; 243:80-87


"In a single institution, extravasation of contrast material into the subcutaneous tissues occurred during attempted intravenous injection in less than 1% of patients,often involved large volumes of contrast material (50-150 ml) and nearly always resolved with conservative management."

Frequency, Management, and Outcome of Extravasation of Nonionic Iodinated Contrast Medium in 69,657 Intravenous Injections
Wang CL et al.
Radiology 2007; 243:80-87

 

© 1999-2020 Elliot K. Fishman, MD, FACR. All rights reserved.