Immediate complications of intravenous contrast for computed tomography imaging in the outpatient setting are rare

Alice Mitchell, Alan E. Jones, James A. Tumlin, Jeffrey Kline

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Objectives: Despite increasing attention to the long-term risks of radiation exposure and contrast-induced nephropathy (CIN), institutional guidelines and patient consent procedures for contrast-enhanced computed tomography (CECT) imaging in the emergency department (ED) setting have focused primarily on more immediate complications, directly attributable to the administration of intravenous (IV) iodinated contrast administration. Thus, this study sought to define the risk of these immediate complications with the overall aim of improving institutional guidelines and patient consent procedures. Methods: This was a prospective, consecutive cohort study of patients undergoing CECT of any body region in the ED, for complications occurring within 1 week of contrast administration, using predefined implicit definitions. Severe complications were defined as any of the following requiring medical or surgical intervention: bronchospasm with acute respiratory failure, airway obstruction, anaphylactoid shock, or acute pulmonary edema. The development of compartment syndrome, lactic acidosis, or pulmonary edema within 1 week of contrast administration was also considered a severe complication. Results: Of 633 patients, only five (0.8%, 95% confidence interval [CI] = 0.3% to 1.8%) reported any immediate complications, all of which were classified as minor. No patient developed a reaction meeting the study definition of a severe complication. Conclusions: The frequency of severe, immediate complications from CECT imaging that includes IV contrast is less than 1%, and the frequency of mild complications is less than 2%. The authors conclude that CECT is associated with a very low rate of severe immediate complications.

Original languageEnglish (US)
Pages (from-to)1005-1009
Number of pages5
JournalAcademic Emergency Medicine
Volume18
Issue number9
DOIs
StatePublished - Sep 2011
Externally publishedYes

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Outpatients
Tomography
Pulmonary Edema
Hospital Emergency Service
Guidelines
Compartment Syndromes
Bronchial Spasm
Lactic Acidosis
Body Regions
Airway Obstruction
Respiratory Insufficiency
Intravenous Administration
Shock
Cohort Studies
Confidence Intervals

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Immediate complications of intravenous contrast for computed tomography imaging in the outpatient setting are rare. / Mitchell, Alice; Jones, Alan E.; Tumlin, James A.; Kline, Jeffrey.

In: Academic Emergency Medicine, Vol. 18, No. 9, 09.2011, p. 1005-1009.

Research output: Contribution to journalArticle

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