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Intravascular radiographic contrast media: issues for family physicians

R B Hash1

  • 1Department of Family and Community Medicine, Mercer University School of Medicine, Macon, GA 31207-0001, USA.

The Journal of the American Board of Family Practice
|March 2, 1999
PubMed

Insights

Family physicians use contrast media for diagnostic tests. Adverse reactions, including anaphylactoid and kidney issues, can occur but are often preventable with risk factor management and proper hydration.

Area of Science:

  • Radiology
  • Diagnostic Imaging
  • Pharmacology

Background:

  • Family physicians commonly order and oversee diagnostic tests utilizing intravascular radiographic contrast media.
  • Understanding potential adverse reactions is crucial for patient safety in diagnostic procedures.

Purpose of the Study:

  • To review adverse reactions associated with intravascular contrast media.
  • To identify risk factors and preventive measures for contrast media-induced adverse events.
  • To discuss management strategies for different types of reactions.

Main Methods:

  • A comprehensive literature search of the MEDLINE database from 1966 to the present was conducted.
  • Key search terms included "contrast media," "adverse reaction," "anaphylaxis," "anaphylactoid," "nephropathy," "renal failure," "kidney failure," and "MRI."
  • Additional relevant sources were identified through back referencing and recent texts.

Main Results:

  • The most common adverse reactions include acute anaphylactoid and cardiovascular events, delayed reactions, and renal effects.
  • Mild acute reactions typically require no intervention, while severe reactions necessitate emergency treatment.
  • Contrast-associated nephropathy risk is elevated in patients with pre-existing renal disease, heart failure, or volume depletion.

Conclusions:

  • Acute reactions can be minimized by identifying risk factors and implementing pretreatment protocols.
  • Optimizing precontrast hydration is effective in reducing contrast-induced nephropathy.
  • While magnetic resonance imaging (MRI) contrast agents may involve smaller volumes, adverse reactions are still possible.
Abstract

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