Safe use of an intravenous power injector for CT: experience and protocol.

Miles, S G; Rasmussen, Jakob Fraes; Litwiller, Tony L.; Osik, A

doi:10.1148/radiology.176.1.2353114

Cited by 58 publications

(32 citation statements)

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“…In spite of the radiologist's efforts to prevent CMEV, it continues to occur in every CT room. In most practices, the reported frequency is less than 1% [3,4,7] . Since the replacement of MI by API, the number of reported CMEV incidents has increased but the relation between CMEV and injection rate remained controversial.…”

Section: Discussionmentioning

confidence: 99%

“…The automatic power injector (API) enables CM to be delivered as a nonfragmented bolus at a high fl ow rate, which is essential for many HCT protocols [3,4] such as CT angiography and multiphasic organ imaging. Although the number of reported extravasations has increased since APIs were introduced in CT scanning, the relationship between the frequency of contrast media extravasation (CMEV) to the injection rate remains debatable [5][6][7] .…”

Section: Introductionmentioning

confidence: 99%

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Contrast Media Extravasation: Manual versus Power Injector

et al. 2005

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Objective: To compare the incidence and complications of extravasation of low-osmolar nonionic contrast media, injected manually and by the automatic power injector (API). Subjects and Methods: Three thousand five hundred and sixty patients underwent contrast-enhanced abdominal and thoracic computerized tomography scan in the Department of Clinical Radiology, Al-Amiri Hospital, Kuwait, between June 1998 and De cember 2002. These patients were prospectively analyzed for contrast media extravasation, its relation to injection rate, cannula insertion and gauge and its complications. 920 patients were administered low-osmolar nonionic contrast media (Ultravist 300, Omni Paque 240 or 300) intravenously by manual injection and 2,640 patients by automatic power injector. Results: Of the 3,560 patients contrast media extravasation occurred in 11 (0.3%). The symptoms were observed in 9 patients (0.3%) in the API group and 2 patients (0.2%) in the manual injection group, respectively. None of the patients had any soft tissue injury. Conclusion: The incidence of contrast media extravasation is not significantly increased by the use of the API. Low-osmolar nonionic contrast media extravasation resulting from the use of API does not cause any morbidity.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Contrast Media Extravasation: Manual versus Power Injector

et al. 2005

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“…al. [1] as well as Miles et al [17]. Over 90% of patients in both groups in which symptoms of acute post-contrast allergic reaction were reported, had received Ultravist 370 through an automatic syringe, a manual syringe having been used in only three of them.…”

Section: Discussionmentioning

confidence: 97%

“…More side effects were reported by patients who received iopromid with an automatic syringe than by those to whom doctors administered it manually. Both Kopp et al [1] and Miles et al [17] suggested that extravasations which can lead to local inflammatory reactions are more common on automatic than in manual injection. This was not confirmed by Jacobs et.…”

Section: Discussionmentioning

confidence: 99%

Incidence of acute allergic reactions to contrast medium following CT examination on the basis of analysis of medical record data – preliminary report

Zdanowski

Szymczewska²,

Dykowska

et al. 2015

Polish Journal of Public Health

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Incidence of acute allergic reactions to contrast medium followingCT examination on the basis of analysis of medical record data -preliminary report Abstract Introduction. A contrast-enhanced CT examination can have negative health implications. It can spark both allergic and other adverse reactions.Aim. The study aimed at analyzing the incidence of acute allergic reactions to Ultravist 370, used as a contrast medium in a CT examination.Material and methods. The analysis of medical records that comprised 12295 patients who had undergone a CT examination. Women accounted for 50.7% of the study participants. Mean age of the patients was 62 years (min. 15; max. 92, SD=10.123). In the study, 6219 patients were examined without using a contrast medium and 6076 individuals underwent a contrast-enhanced CT examination. In the further analysis, Group 1 comprised of 15 patients from the contrastenhanced CT examination group who confirmed being allergic to a contrast medium after the CT examination and Group 2 comprised 49 persons who had reported being allergic to iodine before the CT examination.Results. 15 patients (8 women and 7 men) developed an allergy to Ultravist 370 (contrast medium). An acute allergic reaction was most likely to happen in two groups of patients: between 31-40 and 51-60 years. Some 12 out of 15 patients had no contraindications for taking an iodine-based contrast medium. The most frequent allergic reactions to Ultravist 370 were rash and urticaria (15 patients). Five patients out of those who experienced adverse reactions reported two symptoms of allergy each while other patients reported one symptom only. Patients with mild symptoms of acute reaction to a contrast medium (15 patients) received pharmacotherapy recommended by a radiologist. Some 13 individuals received Solu-Medrol intravenously and 2 patients received Solu-Medrol intravenously and Fenicort intramuscularly.Conclusions. 1. Using Ultravist 370 in patients is safe, since there is very low risk of adverse side effects caused by the application of this contrast medium. 2. In the present study, age, gender, and risk factors contributed to the development of acute allergic reactions. However, due to the small size of the study group, it is obvious that issues like the incidence of symptoms of discomfort or intolerance of the drug need further research. 3. Owing to the fact that essential biochemical tests had not been performed on a large group of patients, doctors referring patients to a CT examination should take care of their own safety by properly preparing themselves for this procedure. 4. It seems essential to develop and implement regular trainings for CT laboratory staff with reference to the following issues: the incidence and nature of acute adverse reactions to non-ionic contrast medium (Ultravist 370), as well as the procedures for dealing with side effects.

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“…The advantage of a power-assisted injection over manual injection or drip infusion has been demonstrated [1,2] and is widely accepted. Particularly in spiral CT where the amount of contrast material, time of injection, and scan delay represent crucial factors and are part of standarized protocols, the advantage of power injecting is self-evident.…”

Section: Introductionmentioning

confidence: 99%

Safe and easy power injection of contrast material through a central line

et al. 1998

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Power-assisted injection of contrast material into an antecubital vein is commonly used in CT and has been proven superior to manual injection. Power-assisted injection through a central line bares the risk of rupturing the line because manual control over the pressure applied by the power injector is lacking. We present a simple safety device which allows manual control of the pressure by means of an interposed three-way stopcock combined with a small syringe for pressure equalization.

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Safe use of an intravenous power injector for CT: experience and protocol.

Cited by 58 publications

References 0 publications

Contrast Media Extravasation: Manual versus Power Injector

Contrast Media Extravasation: Manual versus Power Injector

Incidence of acute allergic reactions to contrast medium following CT examination on the basis of analysis of medical record data – preliminary report

Safe and easy power injection of contrast material through a central line

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