IV Contrast Myths

Credit to Dr Todd Taylor for finding the article and sharing on the ED Listserv.

Article by Anand Swaminathan


Main take-away points:

  • shellfish allergies do not crossover to IV contrast – we shouldn’t even be asking this question
  • pretreatment only helps hives, no statistical significance for major complications
  • interesting discussion between anaphylactic reactions (mast cell degranualtion secondary to antibodies from previous exposure) to anaphylactoid reactions (no antibodies involved)!

Read for yourself!

Will this change your practice patterns?




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    • Todd Taylor on July 11, 2014 at 1:07 pm
    • Reply

    Hey here is the link to a paper on CIN. Contrast induced nephropathy is something that we all need to be up on as we do a ton of contrast studies on very sick patients. The skinny is that they look at GFR rates instead of creatinine numbers to evaluate people for acute kidney injury risk. Anything less than 60 is at risk (take a look at the graph its actually kinda frightening).

    Anyhow they don’t give particular rec for us as far as NS vs LR vs Sodium Bicarb but states the evidence behind sodium bicarb isnt great and that as long as we are volume loading them then it should help.

    Doesn’t give great numbers but 3cc/Kg/Hr for 1 hour before and 6 hours after is a “reasonable” approach. Please be cognizant of this as we almost always have a little time to give these people some fluid before the CT (I actually give everyone ((without contraindications)) fluid before CT scan.

    Hope it helps


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