Are referring clinicians aware of patients at risk from intravenous injection of iodinated contrast media?
OBJECTIVE
The purpose of our study was to assess the level of awareness of referring clinicians to populations at risk for complications of intravascular administration of iodinated contrast media.


METHODS
Two hundred and three physicians from three university hospitals completed an anonymous questionnaire regarding risk factors and contraindications to the intravenous administration of iodinated contrast media. The questionnaire included medical conditions with increased risk for anaphylactoid reaction (asthma, hay fever and food allergy) as well as chemotoxic (ischaemic heart disease, phaeochromocytoma and myasthenia gravis) adverse reactions, some with dependence on renal function (metformin treatment, diabetes mellitus and multiple myeloma). Two additional multiple-choice questions addressed pre-medication protocols and risk of nephrotoxicity in diabetic patients.


RESULTS
Asthma, food allergy and hay fever were recognized as risk factors by 81.3%, 77.8% and 61.6% of respondents respectively, while ischaemic heart disease, phaeochromocytoma and myasthenia gravis were defined as such only by 9.8%, 30.0% and 28.6% respectively. Metformin treatment, diabetes mellitus and multiple myeloma, in the presence of normal renal function, were considered as risk factors by 46.3%, 38.9% and 58.1% of respondents respectively. One of the generally accepted pre-medication protocols was selected by 89.8%. The risk of nephrotoxicity in a diabetic patient was correctly assessed by 63.5% of respondents.


CONCLUSIONS
We found a relatively high awareness among referring clinicians of a potential anaphylactoid reaction and nephrotoxicity due to iodinated contrast media. However, additional chemotoxic adverse reactions are less well known. Future efforts to improve communication between clinicians and radiologists should be focused in this direction.
Konen
Eli
E
Department of Diagnostic Imaging, Chaim Sheba Medical Center, Tel-Aviv, Israel. konen@internet-zahav.net.il
Konen
Osnat
O
Katz
Miriam
M
Levy
Yair
Y
Rozenman
Judith
J
Hertz
Marjorie
M
D058186:Acute Kidney Injury / Q000139:chemically induced; D000707:Anaphylaxis / Q000139:chemically induced; D000075202:Contraindications; D003287:Contrast Media / Q000009:adverse effects*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007275:Injections, Intravenous; D017613:Iodine Compounds / Q000009:adverse effects*; D008505:Medical Staff, Hospital / Q000523:psychology*; D012307:Risk Factors
D003287:Contrast Media; D017613:Iodine Compounds