Frequency and Severity of Acute Adverse Effects of Low Osmolar Iodinated Contrast Media in Contrast-Enhanced Computed Tomography

Background: Nonionic, low osmolar agents are now used nearly universally for intravenous (IV) contrast administration in computed tomography. The osmolarity of a contrast agent is considered to be responsible for adverse effects in patients injected with contrast media. With the increase in its utilization, acute adverse reactions are suspected to rise substantially. Regardless of the usage of low osmolar non-ionic agents to reduce adverse effects, a large number of reactions are still experienced by patients. However, the frequency of immediate adverse contrast reactions to various low osmolar non‐ionic iodinated contrast media is not well studied. A basic understanding of the occurrence, risk factors and clinical features of these reactions is important as it can help in ensuring optimal patient care. Objective: To determine the frequency and severity of acute adverse reactions related to administration of low osmolar iodinated contrast media to patients during contrast-enhanced computed tomography scans. Methods: A cross-sectional study of intravascular doses of low osmolar non-ionic iodinated contrast media administered from October 2018 to February 2018 was conducted on patients undergoing CT examinations at Combined Military Hospital, Lahore. Acute adverse effects were characterized by using the data collected. These effects were investigated for determining the frequency and severity of reactions. Results: A total of 328 low osmolar iodinated contrast doses were administered to patients coming for CT examinations. 209 cases of acute adverse effects (63.72%) were identified. 90 out of 139 (64.75%) females, 117 out of 189 (61.90%) males were affected. Mild reactions were in the majority with the most common being nausea, sweating, and change in taste. Two cases of moderate reactions and no severe/fatal reactions were found over the study period. One case necessitated transfer to the emergency for urgent care. Female patients were affected more than males. Conclusion: Acute adverse reactions to the administration of low-osmolar non-ionic iodinated contrast agents are rare. The severity of these reactions is governed by multiple aspects of an examination, but the majority of them are mild. Moderate and severe reactions occur infrequently. Ideal patient care can be very helpful to combat these reactions.