Adverse Reactions to Radiographic Contrast Media Administered by the Intravascular Route

The experience at the Royal Adelaide Hospital over four years with reported adverse reactions to intravascularly administered radiographic contrast media is compared with those from prospective studies reported in the literature. There were nineteen severe reactions, three of which were fatal. Eight occurred during a radiological examination conducted outside the hospital and were attended by a mobile intensive care team from the hospital34. Intradermal skin testing was performed on ten patients and estimations of serum immunoglobulins and complement factors were carried out in twelve patients, five of whom also had complement and immunoglobulin estimations shortly after the severe reaction. Analysis of this data suggests that intradermal skin testing and the monitoring of immunoglobulins and complement factors appear to have little predictive value. Current concepts of the mechanisms involved in these reactions, the treatment of reactions, the precautions that should be taken and the usefulness of screening tests are discussed.