"In patients with a history of adverse reactions, use of a different low or iso-osmolar agent than the one that caused the previous reaction is recommended 1,8,9,10."
"moderate: symptoms that are more prominent and demand medical attention with specific treatment, e.g. marked urticaria, severe vomiting, bronchospasm, facial oedema, laryngeal oedema, and vasovagal attacks"
"The estimated mortality rate due do adverse contrast media reactions ranges between 2 to 9 cases per 1 million administrations or 0.0009% 3."
"Although these reactions are commonly called contrast allergies or allergic reactions, the use of the word allergy is unhelpful as the majority of the reactions are not immune-mediated, and therefore not true allergic reactions. Indeed, in the majority of cases, no true allergy testing ever occurs 6."
"Although the exact mechanisms responsible for adverse reactions to contrast media are not entirely understood, they can be broadly divided, based on our current proposed mechanisms, into allergic-like and physiologic reactions. Understanding the differences in these types of reactions is important, as incorrectly diagnosing physiologic reactions as allergic-like can lead to unnecessary premedication of patients who need to undergo additional contrast-enhanced studies 3."
"Although the exact mechanisms responsible for adverse reactions to contrast media are not entirely understood, they can be broadly divided, based on our current proposed mechanisms, into allergic-like and physiologic reactions. Understanding the differences in these types of reactions is important, as incorrectly diagnosing physiologic reactions as allergic-like can lead to unnecessary premedication of patients who need to undergo additional contrast-enhanced studies 3."
"high BMI 11"
"RANZCR guidelines 1 for severe reactions recommend:"
"self-limiting manifestations that usually resolve without any specific treatment, e.g. nausea, vomiting, flushing, pruritus, mild urticaria, and headache"
"moderate: symptoms that are more prominent and demand medical attention with specific treatment, e.g. marked urticaria, severe vomiting, bronchospasm, facial oedema, laryngeal oedema, and vasovagal attacks"
"reactions that usually represent a progression of the moderate symptoms and are life-threatening, e.g. respiratory arrest, cardiac arrest, pulmonary oedema, convulsions, and cardiogenic shock"
Expected headings
"Acute contrast reaction"
"Delayed contrast reaction"
"Route of administration"
"Prophylaxis"
"Use of an alternate agent"
"Corticosteriod premedication"
"Antihistamine premedication"
"Contrast media warming"
"Fasting"
"Treatment"
"Prognosis"
"Contrast media adverse reactions, popularly but erroneously referred to as contrast allergies (see Terminology below), are an uncommon group of symptoms and signs, with different degrees of severity, that may occur after the administration of various contrast media, typically after iodinated contrast media. Acute reactions after gadolinium contrast media and ultrasound contrast agents are much rarer, approach and treatment of those is the same as in the case of iodinated media 9."
"Indeed this has been reported following exposure during most fluoroscopic procedures, including enemas, hysterosalpingography, sialography, arthrograms and renal tract studies 7."
"While premedication with corticosteroids, with or without antihistamines, has been shown to reduce the occurrence and severity of anaphylaxis, there is a lack of evidence that it reduces the risk of death following breakthrough anaphylactic reaction 1."
"There are many myths and misconceptions on the risk factors of adverse contrast media reactions:"
"There is no compelling evidence whether the warming of iodinated contrast media to body temperature decreases the risk of adverse reactions. It is nevertheless regarded as best practice, because it is beneficial for high flow injections and high viscosity media, might reduce the risk of extravasations, and is subjectively more comfortable for patients 3,9."
"allergies to elemental iodine do not exist; it is due to allergy to other chemical moieties 6"
"self-limiting manifestations that usually resolve without any specific treatment, e.g. nausea, vomiting, flushing, pruritus, mild urticaria, and headache"
"moderate: symptoms that are more prominent and demand medical attention with specific treatment, e.g. marked urticaria, severe vomiting, bronchospasm, facial oedema, laryngeal oedema, and vasovagal attacks"