![]() ![]() In our institution, as a general rule, patients with a history of severe or moderate adverse reactions to contrast do not undergo contrast-enhanced examinations. The efficacy of premedication is still unclear, and in particular the frequency of BTR after gadolinium contrast media administration has been little reported. Although some guidelines have proposed oral steroid premedication protocols to prevent adverse reactions, some patients may have reactions to contrast media in spite of premedication (breakthrough reaction BTR). 1) a history of previous acute reaction to contrast media, 2) a history of asthma, and 3) a history of allergies requiring medical treatment. Patient-related risk factors for acute adverse reactions to these contrast media have been established, i.e. These contrast media are relatively safe, but adverse reactions to contrast media are still an important clinical issue. Two of the most common intravenous contrast media are iodinated contrast media for computed tomography (CT) and angiography, and gadolinium contrast media for magnetic resonance imaging (MRI). Intravenous contrast media are essential for modern medical imaging. This study by no means proves the efficacy of premedication, but provides some support for following a premedication protocol to improve safety of contrast-enhanced examinations when prior adverse reactions are mild, or when there is a history of asthma. Incidence of BTRs when following the premedication protocol was low. No patient who had a mild index reaction (IR) had a severe BTR. There were nine BTR (4.5%) for iodinated contrast media, and only one BTR (1.9%) for gadolinium contrast media: eight were mild and one was moderate. There were 198 contrast enhanced CTs and 54 contrast enhanced MRIs. Of these, 152 were for prior acute adverse reactions to contrast media, 85 were for a history of bronchial asthma, and 15 were for other reasons. The protocol was applied to a total of 252 examinations (153 patients, ages 15–87 years 63 males, 90 females). MethodsĪll iodinated and gadolinium contrast-enhanced radiologic examinations between August 2011 and February 2013 for which the premedication protocol was applied in our institution were assessed for BTRs. ![]() The purpose of this study was to assess the frequency, type and severity of BTR when following an oral steroid premedication protocol. Adverse reactions to iodinated and gadolinium contrast media are an important clinical issue. ![]()
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