Original article. Incidence and severity of acute adverse reactions to intravenous iodinated contrast media: 8-year experience in King Chulalongkorn Memorial Hospital

Background: Increasing numbers of acute adverse reactions to contrast media are being seen. Institutional information about incidence and severity of acute adverse reactions to contrast media is essential to inform radiologists of the both common and life-threatening acute adverse reactions encountered.

Objectives: We determined the overall, type-specific and severity of acute adverse reactions to intravenous iodinated contrast media at King Chulalongkorn Memorial hospital between January 2002 and December 2009.

Methods: This retrospective study reviewed 663 report forms for acute adverse reactions to contrast media among 74,010 intravenous iodinated contrast injections using five types of contrast media including meglumine/sodium ioxitalamate, iohexol, iopamidol, iopromide, and iobitridol.

Results: The overall incidence of acute adverse reactions to iodinated contrast media was about 0.9%. Of these 0.8% were minor, and 0.1% were major reactions. The majority of minor reactions were urticaria and the majority of major reactions were facial edema. One contrast-related death was reported. Incidence of acute adverse reactions to nonionic contrast media was 0.58%, and was 4.29 % in the ionic group. The type-specific incidence of acute adverse reactions was 4.29% for meglumine/sodium ioxitalamate, 0.82% for iohexol, 0.29% for iopamidol, 0.65% for iopromide, and 0.25% for iobitridol.

Conclusion: Acute adverse reactions to intravenous iodinated contrast media account for less than one percent of injections. The incidence is higher in the ionic contrast media group. The majority of reactions are mild. However, severe reactions can still be encountered and death related to contrast media exist.