Large-volume iodinated contrast medium extravasation: low frequency and good outcome after conservative management in a single-centre cohort of more than 67,000 patients

Chih Hsiang Ko, Shee Yen Tay, Hsiu Chin Chang, Wing P. Chan

研究成果: 雜誌貢獻文章

1 引文 (Scopus)

摘要

Objectives: Our aim was to retrospectively investigate the frequency and outcome of large-volume iodinated contrast medium (CM) extravasation in our institution and to compare our management protocol to current practice. Methods: Institutional review board approval was obtained, and informed consent was waived because the study was retrospective. From January 2008 to September 2016, radiological examinations with intravenous non-ionic iodinated CM administration were performed in 67,129 patients. Contrast medium extravasation events on CT scans and intravenous pyelograms but not on angiograms were included. All data were collected prospectively and stratified according to age, injection method (manual vs auto-injection), prevention of extravasation by various means (including intercom alarm), management of extravasation (routine application of silver sulfadiazine ointment, clobetasol propionate cream, and damp gauze at room temperature), etc. Results: The incidence of large-volume CM extravasation was very low (0.04% [27/67,129] overall; 0.03% related to manual injection [age range, 59-92 years; mean, 75.4 years], and 0.045% related to auto-injection [age range, 36-86 years; mean, 65.8 years]). The CM extravasation volume in majority of patients was 20–40 ml in 5 of 9 patients (55.6%) in the manual injection group and 14 of 18 (77.8%) in the auto-injection group. Swelling and pain were the most common symptoms. No patient developed severe signs or needed surgical intervention. Conclusions: Results show a very low incidence of large-volume CM extravasation without severe complications or sequelae. The casual effect between our protocols and good outcome cannot be scrutinised thoroughly because the study lacks a control group and is retrospective. Key Points: • The incidence of large-volume contrast medium extravasation (≥20 ml) was 0.04%.• No patient needed surgical intervention, and most recovered within 7 days.• Each element of our management protocol contributed to good outcome.
原文英語
頁(從 - 到)5376-5383
頁數8
期刊European Radiology
28
發行號12
DOIs
出版狀態已發佈 - 十二月 1 2018

指紋

Extravasation of Diagnostic and Therapeutic Materials
Injections
Incidence
Clobetasol
Silver Sulfadiazine
Urography
Research Ethics Committees
Ointments
Informed Consent
Contrast Media
Conservative Treatment
Angiography
Retrospective Studies
Pain
Control Groups
Temperature

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

引用此文

@article{5915ab0bf16848d3adfa3d2c1869c401,
title = "Large-volume iodinated contrast medium extravasation: low frequency and good outcome after conservative management in a single-centre cohort of more than 67,000 patients",
abstract = "Objectives: Our aim was to retrospectively investigate the frequency and outcome of large-volume iodinated contrast medium (CM) extravasation in our institution and to compare our management protocol to current practice. Methods: Institutional review board approval was obtained, and informed consent was waived because the study was retrospective. From January 2008 to September 2016, radiological examinations with intravenous non-ionic iodinated CM administration were performed in 67,129 patients. Contrast medium extravasation events on CT scans and intravenous pyelograms but not on angiograms were included. All data were collected prospectively and stratified according to age, injection method (manual vs auto-injection), prevention of extravasation by various means (including intercom alarm), management of extravasation (routine application of silver sulfadiazine ointment, clobetasol propionate cream, and damp gauze at room temperature), etc. Results: The incidence of large-volume CM extravasation was very low (0.04{\%} [27/67,129] overall; 0.03{\%} related to manual injection [age range, 59-92 years; mean, 75.4 years], and 0.045{\%} related to auto-injection [age range, 36-86 years; mean, 65.8 years]). The CM extravasation volume in majority of patients was 20–40 ml in 5 of 9 patients (55.6{\%}) in the manual injection group and 14 of 18 (77.8{\%}) in the auto-injection group. Swelling and pain were the most common symptoms. No patient developed severe signs or needed surgical intervention. Conclusions: Results show a very low incidence of large-volume CM extravasation without severe complications or sequelae. The casual effect between our protocols and good outcome cannot be scrutinised thoroughly because the study lacks a control group and is retrospective. Key Points: • The incidence of large-volume contrast medium extravasation (≥20 ml) was 0.04{\%}.• No patient needed surgical intervention, and most recovered within 7 days.• Each element of our management protocol contributed to good outcome.",
keywords = "Contrast media, Incidence, Injections, Safety, Therapeutics",
author = "Ko, {Chih Hsiang} and Tay, {Shee Yen} and Chang, {Hsiu Chin} and Chan, {Wing P.}",
year = "2018",
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doi = "10.1007/s00330-018-5514-z",
language = "English",
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journal = "European Radiology",
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TY - JOUR

T1 - Large-volume iodinated contrast medium extravasation

T2 - low frequency and good outcome after conservative management in a single-centre cohort of more than 67,000 patients

AU - Ko, Chih Hsiang

AU - Tay, Shee Yen

AU - Chang, Hsiu Chin

AU - Chan, Wing P.

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Objectives: Our aim was to retrospectively investigate the frequency and outcome of large-volume iodinated contrast medium (CM) extravasation in our institution and to compare our management protocol to current practice. Methods: Institutional review board approval was obtained, and informed consent was waived because the study was retrospective. From January 2008 to September 2016, radiological examinations with intravenous non-ionic iodinated CM administration were performed in 67,129 patients. Contrast medium extravasation events on CT scans and intravenous pyelograms but not on angiograms were included. All data were collected prospectively and stratified according to age, injection method (manual vs auto-injection), prevention of extravasation by various means (including intercom alarm), management of extravasation (routine application of silver sulfadiazine ointment, clobetasol propionate cream, and damp gauze at room temperature), etc. Results: The incidence of large-volume CM extravasation was very low (0.04% [27/67,129] overall; 0.03% related to manual injection [age range, 59-92 years; mean, 75.4 years], and 0.045% related to auto-injection [age range, 36-86 years; mean, 65.8 years]). The CM extravasation volume in majority of patients was 20–40 ml in 5 of 9 patients (55.6%) in the manual injection group and 14 of 18 (77.8%) in the auto-injection group. Swelling and pain were the most common symptoms. No patient developed severe signs or needed surgical intervention. Conclusions: Results show a very low incidence of large-volume CM extravasation without severe complications or sequelae. The casual effect between our protocols and good outcome cannot be scrutinised thoroughly because the study lacks a control group and is retrospective. Key Points: • The incidence of large-volume contrast medium extravasation (≥20 ml) was 0.04%.• No patient needed surgical intervention, and most recovered within 7 days.• Each element of our management protocol contributed to good outcome.

AB - Objectives: Our aim was to retrospectively investigate the frequency and outcome of large-volume iodinated contrast medium (CM) extravasation in our institution and to compare our management protocol to current practice. Methods: Institutional review board approval was obtained, and informed consent was waived because the study was retrospective. From January 2008 to September 2016, radiological examinations with intravenous non-ionic iodinated CM administration were performed in 67,129 patients. Contrast medium extravasation events on CT scans and intravenous pyelograms but not on angiograms were included. All data were collected prospectively and stratified according to age, injection method (manual vs auto-injection), prevention of extravasation by various means (including intercom alarm), management of extravasation (routine application of silver sulfadiazine ointment, clobetasol propionate cream, and damp gauze at room temperature), etc. Results: The incidence of large-volume CM extravasation was very low (0.04% [27/67,129] overall; 0.03% related to manual injection [age range, 59-92 years; mean, 75.4 years], and 0.045% related to auto-injection [age range, 36-86 years; mean, 65.8 years]). The CM extravasation volume in majority of patients was 20–40 ml in 5 of 9 patients (55.6%) in the manual injection group and 14 of 18 (77.8%) in the auto-injection group. Swelling and pain were the most common symptoms. No patient developed severe signs or needed surgical intervention. Conclusions: Results show a very low incidence of large-volume CM extravasation without severe complications or sequelae. The casual effect between our protocols and good outcome cannot be scrutinised thoroughly because the study lacks a control group and is retrospective. Key Points: • The incidence of large-volume contrast medium extravasation (≥20 ml) was 0.04%.• No patient needed surgical intervention, and most recovered within 7 days.• Each element of our management protocol contributed to good outcome.

KW - Contrast media

KW - Incidence

KW - Injections

KW - Safety

KW - Therapeutics

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