Late adverse reactions after intravascular iodinated contrast medium include symptoms such as nausea, vomiting, headache, itching, skin rash, musculoskeletal pain, and fever. The report and guidelines were discussed at the 8th European Symposium on Urogenital Radiology in Genoa. Based on the available information, simple guidelines have been drawn up. An extensive literature search was carried out and summarized in a report. The Contrast Media Safety Committee of the European Society of Urogenital Radiology decided to review the literature and to issue guidelines. They have received increasing interest over the past decade, but their prevalence remains uncertain and their pathophysiology is not fully understood. Late adverse reactions to intravascular iodinated contrast media are defined as reactions occurring 1 h to 1 week after contrast medium injection. No preference was given to either technique when evaluating the Ao or rCPA but the BT technique was shown to be shorter in duration and resulted in less DLP than the TB technique. The mean DLP did not differ significantly between the two techniques (p = 0.17). The mean mA for the BT technique was significantly lower than the TB technique (p = 0.03), as was the mean CTDI(vol) (p = 0.001). The BT technique was conducted in a significantly shorter time period than the TB technique (p = 0.03). The attenuation in the Ao (BT = 660 52 HU ± 138 49 HU, TB = 469 82 HU ± 199 52 HU, p = 0.13) and in the rCPA (BT = 606 34 HU ± 143 37 HU, TB = 413 72 HU ± 174.99 HU, p = 0.28) did not differ significantly between the two techniques. Additional observations included the study duration, milliAmpere (mA), computed tomography dose index volume (CTDI) and dose length product (DLP). ![]() ![]() Mean attenuation in HU was measured in the aorta (Ao) and right caudal pulmonary artery (rCPA). The full dose of the contrast agent was then administered and the scans were conducted at optimal times as identified from time attenuation curves. For the TB technique, the dogs received a test dose of 15% of 2 mL/kg of 300 mgI/mL iodinated contrast agent, followed by a series of low dose sequential scans. Scans were initiated when the contrast in the aorta reached 150 Hounsfield units (HU). For the BT technique, 2 mL/kg of 300 mgI/mL iodinated contrast agent was injected intravenously. Different pharmacological agents have been tested, but the use of iso-osmolar or hypo-osmolar contrast agents along with continuous hydration before, during, and after the intervention are the only methods that have currently achieved adequate nephroprotection.Computed tomography thoracic angiography studies were performed on five adult beagles using the bolus tracking (BT) technique and the test bolus (TB) technique, which were performed at least two weeks apart. As there is no specific treatment available for this condition, emphasis should be placed on prevention. It is the third leading cause of in-hospital acute kidney injuries, and it leads to an increase in morbidity and mortality of the population. Contrast-induced nephropathy is defined as an absolute (≥ 0.5 mg/dL) or relative increase (≥ 25%) of the serum creatinine within 24-72 hours post-exposure to the contrast media. It is estimated that the incidence is about 0-5% among the population with normal renal function however it can reach 12-27% among people with altered baseline renal function. The use of contrast media in the diagnostic and therapeutic medical arsenal can cause adverse effects, such as renal toxicity and acute kidney injury, known as contrast-induced nephropathy. Se han probado distintos agentes farmacológicos, sin embargo, hoy en día los únicos métodos que han logrado asegurar adecuada nefroprotección son el uso de agentes de contraste isoosmolares o de baja osmolaridad junto con hidratación continua del paciente antes, durante y después de la intervención. Por tanto, el énfasis se realiza en la prevención. No se dispone de un tratamiento específico para esta entidad. Es la tercera causa de injuria renal aguda intrahospitalaria y conlleva un aumento en la morbimortalidad de la población. La nefropatía inducida por contraste se define como un aumento absoluto (≥ 0,5 mg/dl) o relativo (≥ 25%) de la creatinina sérica en 24-72 h postexposición al medio de contraste. ![]() Se estima que en la población con función renal normal la incidencia es del 0-5% sin embargo, en personas con alteración de la función renal basal puede llegar a un 12-27%. El uso de medios de contraste dentro del arsenal diagnóstico y terapéutico médico puede ocasionar efectos adversos como toxicidad renal e injuria renal aguda, conocida como nefropatía inducida por contraste.
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