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KMID : 1131320150170020097
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Journal of Korean Society of Computed Tomographic Technology
2015 Volume.17 No. 2 p.97 ~ p.114
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Acute Adverse Reaction to Contrast Media : A Retrospective Study
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Kim Tae-Eun
Chung Yong-Hwan
KIm Seo-Hyeon
Park Guan-Jung
Gwon Sun-Ahn
Min Kwan-Hong
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Abstract
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Purpose : The purpose of this study is to find the way to minimize the acute adverse reaction to contrast media by analyzing acute adverse reactions of the patients examined the contrastenhanced CT scan through the acute adverse reaction process.
Materials and Methods : The subjects of the experiment are 471,692 patients examined by using contrast media out of 621, 181 who examined the CT scan in June 2007 to December 2014. The number of the patients with acute adverse reactions is presented 4589 (0.99%). Depending on the application of the acute adverse reaction process, rate of the acute adverse reaction was analyzed monthly. The acute adverse reaction process in this study is as follows.
In the case of the new patient, they were injected to intravascular fluid. mixed Contrast media with Normal Saline (1:50) by using 10cc syringe. If there was no adverse reactions. examination was progressing. If adverse reactions are found, the patient needs a treatment in Allergy and clinical immunology. We examined the contrast-enhanced CT scan after pre-medication for each condition. Among previous-visited patient those who were found acute adverse reaction may be examined the contrast-enhanced CT scan after pre-medication for each condition.
Patients who are taking diabetes medicine such as Metformin should be checked renal function before the contrast-enhanced CT scan. Since 2012, only one Contrast media has been used for the minimization of acute adverse reactions instead of using a variety of Contrast media for each CT scan and the other kinds of Contrast media may be used for the previous-visited patients who were found the acute adverse reaction such as symptom 3. The acute adverse reaction to contrast media can be classified as 3 steps, such as Symptom 1, Symptom 2, Symptom 3 and Analyzing was performed monthly.
Results : During the period, the number of contrast-enhanced CT scan for each month increased approximately 44% from 4050 to 5834 in 2007, 2014 respectively. However. in the case of the number of acute adverse reaction, it decreased about 45% from 47 to 26 in 2007, 2014 respectively. Mild cases of acute adverse reactions decreased about 42% from 42 to 23 from 2007 to 2014. Moderate cases of acute adverse reactions decreased about 33% from 4.6 to 3.1 in 2007, 2014 respectively. Severe cases of acute adverse reactions decreased about 25% from 0.4 to 0.3 in 2007, 2014 respectively.
Results by dividing the number of contrast-enhanced CT scan into the acute adverse reaction shows the incidence of acute adverse reactions monthly were 47 cases out of average 4050 cases in 2007 (1.17%). in 2014 the cases decreased by approximately 62%, 26 out of 5834 compared to 2007 (0.45%).
Conclusions : According to Food and Drug treatment department, as the CT scan is steadily increasing, adverse reactions to contrast media increase annually. However, the results came out conversely in the study of our hospital. Regardless of the antihistamine and corticosteroid IV injection, this applies to prevent adverse reactions to contrast media in many hospitals, if patients have a history of acute adverse reactions, undiluted contrast media tests are performed after pre-medication. And we applied the process in accordance with the GFR (glomerular filtration rate. less than GFR) to prevent the lactic acidosis. which mortality rate shows about 50% when diabetic patients examined the contrast-enhanced CT scan. In addition. put together a variety of contrast media in only one contrast media. Also when severe patients examine the contrast-enhanced CT scan. the other kinds of contrast media was used. As a result. Acute adverse reactions monthly divided by the number of contrast-enhanced CT scan monthly, called Acute adverse reactions incidence, showed a 62% reduction results. It means these processes that applied in our hospital contribute to minimize the acute adverse reaction to contrast media.
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KEYWORD
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Contrast media, Acute adverse reaction, Metformin, GFR
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