Incidence of contrast medium extravasation for CT and MRI in a large academic medical centre: A report on 502,391 injections

Shaqdan, Khalid W.; Aran, Shima; Thrall, James H.; Abujudeh, Hani H.

doi:10.1016/j.crad.2014.08.004

Cited by 42 publications

(76 citation statements)

References 16 publications

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“…Our rate was consistent with the reported range of 0.06-0.9 % for CT injections in different studies [11][12][13][14][15][16][17][18]37] (Table 2). The majority of these reactions are mild and symptoms include swelling or tightness, warmth or pain at the site of injection, paraesthesias and itching [37].…”

Section: Discussionsupporting

confidence: 94%

“…The extravasation rate seems to be 10 times higher in deep brachial IV cannulation than antecubital cannulation (6 % and 0.6 %, respectively) [38]. Extravasation in CT is reported to occur more in women, inpatients and patients older than 60 years [11]. Most of the extravasations occur in antecubital fossa injections, with gauge 20 catheters, injection rate of 2-3 ml/s and the volume of extravasation is usually between 10-49 ml [11].…”

Section: Discussionmentioning

confidence: 95%

“…A lot of data is published on extravasation and adverse drug reactions in CT [8][9][10][11][12][13][14][15][16][17][18]. Less is published on other safety incidents in CT, such as skin injuries during transport or examination, intravenous line incidents, staffs' occupational injuries, physical or verbal violence, incidental extubations, environment or equipment failures, intra-and inter-hospital service coordination errors, and diagnostic mistakes.…”

Section: Introductionmentioning

confidence: 96%

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 96%

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“…In addition, higher injection rates are cited as a reason, even though there are studies that could not prove a connection between the injection rate and extravasation [15]. Of approximately 350 000 contrast medium injections for CT examinations, 451 resulted in extravasation [16]. The extravasation rate was 0.13 %; among women it was 0.15 %, somewhat higher than for men, at 0.11 %.…”

Section: Contrast Media Extravasation In Radiologymentioning

confidence: 99%

“…According to Shaqdan et al the incidence of extravasation during MRI was 0.06 % (90 cases after 150 000 injections). None of the documented events resulted in severe complications [16].…”

Section: Contrast Media Extravasation In Radiologymentioning

confidence: 99%

Contrast Media Extravasation in CT and MRI – A Literature Review and Strategies for Therapy

Mandlik

Prantl

Schreyer

2018

Fortschr Röntgenstr

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Background Contrast extravasation events in daily radiological routine may lead to serious complications, especially during CT examinations. The resulting symptoms may vary from local pain up to skin ulcers, necrosis or even acute compartment syndrome.There are no uniformly accepted radiological guidelines or recommendations regarding detection and treatment of extravasation events and immanent complications in a timely manner. Method Systematic literature research considering the last 35 years via PubMed using search terms “contrast medium extravasation/paravasation”. Results In the literature, there are conservative management approaches of contrast media extravasation without major evidence base, such as unguent dressings, cooling or splinting. This therapy is mostly symptomatic. Additionally, various invasive techniques are described. We discuss these techniques in the context of contemporary literature, such as the hyaluronidase Injection into the site of extravasation, suction/aspiration technique including flushing of the affected tissue areas and the squeezing technique. However, most citations lack scientific evidence: many articles include anecdotal enumerations, case studies or cite publications from the era, when ionic high osmolar contrast media was state-of-the-art. Besides, many authors derive their extravasation management from studies, where agents other than contrast media were investigated. Conclusion After detailed literature review, we suggest early (plastic) surgical consultation when non-ionic, low-osmolar contrast medium extravasation is about 150 cc or more. In case of extravasation less than 150 cc but in presence of additional symptoms such as impaired perfusion or altered sensibility, the (plastic) surgeon should also be consulted instantly. We do not recommend any invasive first line therapy when contrast media extravasation is less than 150 cc and the patient presents no additional symptoms, besides swelling and local pain. Nevertheless continuous monitoring and accurate conservative management such as active cooling and elevation, splinting of the affected extremity are mandatory as early detection of critical symptoms helps to initiate prompt surgical intervention and avoid sequelae. Key Points Citation Format

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Rates of safety incident reporting in MRI in a large academic medical center

Mansouri

Aran

Harvey

et al. 2015

J. Magn. Reson. Imaging

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Incidence of contrast medium extravasation for CT and MRI in a large academic medical centre: A report on 502,391 injections

Cited by 42 publications

References 16 publications

How often are Patients Harmed When They Visit the Computed Tomography Suite? A Multi-year Experience, in Incident Reporting, in a Large Academic Medical Center

How often are Patients Harmed When They Visit the Computed Tomography Suite? A Multi-year Experience, in Incident Reporting, in a Large Academic Medical Center

Contrast Media Extravasation in CT and MRI – A Literature Review and Strategies for Therapy

Rates of safety incident reporting in MRI in a large academic medical center

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