Adverse effects of contrast media: incidence, prevention and management

Although contrast media are relatively well tolerated, a non-life-threatening, moderate reaction requiring some treatment occurs in 1 to 2% of patients receiving ionic high-osmolar contrast media and in 0.2 to 0.4% of patients receiving non-ionic low-osmolar contrast media. Severe, life-threatening reactions can be expected in about 0.2% of patients after injection of ionic high-osmolar and 0.04% after non-ionic low-osmolar contrast media. Prompt recognition and treatment are invaluable in blunting an adverse response of a patient to radiographic contrast material, and may prevent a reaction from becoming severe or even life-threatening. Some reactions can be prevented by pretreatment before administration of contrast media. Knowledge, training and preparation are crucial in guaranteeing appropriate and effective therapy in the event of an adverse contrast-related event. Radiologists and their staff should review treatment protocols regularly so that each can accomplish his or her role efficiently.