Adverse reactions to nonionic iodine in contrast-enhanced computed tomography: usefulness of monitoring vital signs.
OBJECTIVE
To report on adverse reactions to intravenous nonionic iodine contrast media and evaluate the usefulness of monitoring vital signs.


METHODS
A prospective study of 1537 consecutive patients who received contrast-enhanced CT with nonionic iodine was performed. Systolic and diastolic arterial blood pressure, pulse rate and arterial blood oxygen saturation were monitored. Severity of adverse reactions was classified as minor, intermediate and severe.


RESULTS
A total of 64 adverse reactions developed in 57 patients. The overall prevalence was 3.7% (57/1537). The most common symptom was nausea (18/64) followed by pharyngeal discomfort (11/64). One patient had a severe reaction consisting of prolonged hypotension. Four patients had an intermediate reaction, three transient hypotension or hypertension and one extensive urticaria and facial edema. In two out of four patients who became hypotensive or hypertensive, the reactions developed without any obvious clinical symptoms.


CONCLUSIONS
Severe or life-threatening acute adverse reactions to intravenous nonionic iodine contrast media may develop without any obvious clinical symptoms. Monitoring vital signs is very helpful for early detection.
Department of Dental Radiology and Radiation Research, Faculty of Dentistry, Tokyo Medical and Dental University, Japan.
T
T
Kurabayashi
M
M
Ida
H
H
Fukayama
N
N
Ohbayashi
N
N
Yoshino
T
T
Sasaki
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000187:drug effects; D002648:Child; D003287:Contrast Media / Q000009:adverse effects*; D004341:Drug Evaluation; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000139:chemically induced; D007022:Hypotension / Q000139:chemically induced; D007455:Iodine / Q000009:adverse effects*; D007472:Iohexol / Q000009:adverse effects; D007479:Iopamidol / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000706:statistics & numerical data*; D009325:Nausea / Q000139:chemically induced; D010100:Oxygen / Q000097:blood; D011446:Prospective Studies; D011674:Pulse; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014283:Triiodobenzoic Acids / Q000009:adverse effects
D003287:Contrast Media; D014283:Triiodobenzoic Acids; C033300:iotrolan; D007472:Iohexol; D007455:Iodine; D007479:Iopamidol; D010100:Oxygen