Life-Threatening Reactions with Ionic Contrast Medium: A Six-Year Experience

Serious reactions to intravascular contrast medium are described. Predominant findings were vascular collapse, asystole, acute myocardial infarction and anaphylactoid reaction. The incidence of life-threatening reactions was 5 out of 5431 cases or 0.09%. The highest incidence, was in the 70-year-old group. Immediate successful resuscitation rate was 80%; overall successful resuscitation is 60%. Fatal reactions to contrast medium occur often without warning, and the earlier the reaction occurs, the less likelihood of successful resuscitation. The mortality rate was 2/5431 cases, or 0.037%. One patient died immediately during contrast administration, while another developed serious reaction during the contrast injection but death was delayed for three days with intensive medical treatment. Elderly patients with cardiopulmonary compromise status are most susceptible. For this reason, it is recommended that nonionic contrast medium be used for elderly patients, for the high risk group with cardiopulmonary disorders or for patients with a history of allergy.