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Contrast-induced anaphylaxis: does it occur in the medical environment and is it being responded to appropriately?

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Japanese Journal of Radiology Aims and scope Submit manuscript

Abstract

Purpose

To analyze the appropriateness of primary response for anaphylaxis due to iodinated contrast media (ICM) or gadolinium-based contrast agents (GBCA).

Materials and methods

This retrospective study included all patients in whom intravenous contrast agents (five types of ICMs and four types of GBCAs) were administered at our hospital between April 2016 and September 2021. For the patients who developed anaphylaxis, we obtained data on the time records of contrast injection, anaphylaxis onset, and intramuscular adrenaline (epinephrine) administration.

Results

Of the 76,555 ICM and 30,731 GBCA administrations, anaphylaxis occurred in 49 cases (0.05%), and in 48 cases (98.0%) the onset was within 30 min after administration with widely distributed times (median, 7.5 min; interquartile range, 4.5–10.8 min; max, 26 min). Intramuscular adrenaline administration was performed in 43 cases (87.8%), and this was done within five minutes after the onset in 37 cases (75.5%). Only in 24 cases (49.0%), there were time records of both the onset and adrenaline administration (if performed).

Conclusion

Anaphylaxis occurred within 30 min after contrast injection in the majority of the cases, but times were widely distributed. Only in 75.5% of cases, appropriate primary treatment was performed, and the importance of keeping exact time records in patients’ charts should be re-emphasized.

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Funding

Yasuhiro Fukushima has an endowed chair provided by Siemens Healthineers.

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Authors and Affiliations

  1. Department of Applied Medical Imaging, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma, 371-8511, Japan

    Yasuhiro Fukushima

  2. Department of Radiology, Gunma University Hospital, 3-39-15 Showa, Maebashi, Gunma, 371-8511, Japan

    Takayuki Suto & Hiromi Hirasawa

  3. Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma, 371-8511, Japan

    Yoshito Tsushima

Authors
  1. Yasuhiro Fukushima
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  2. Takayuki Suto
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  3. Hiromi Hirasawa
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  4. Yoshito Tsushima
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Correspondence to Yasuhiro Fukushima.

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Fukushima, Y., Suto, T., Hirasawa, H. et al. Contrast-induced anaphylaxis: does it occur in the medical environment and is it being responded to appropriately?. Jpn J Radiol 41, 1022–1028 (2023). https://doi.org/10.1007/s11604-023-01427-w

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  • DOI: https://doi.org/10.1007/s11604-023-01427-w

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