tag:blogger.com,1999:blog-4841322830021321680.post8946105708451576871..comments2024-03-22T11:46:48.338+07:00Comments on RiT radiology: ACR-Proposed Premedication Regimen to Reduce Contrast ReactionsRathachai Kaewlai, MD (รัฐชัย)http://www.blogger.com/profile/17817884032874584169noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-4841322830021321680.post-59423723282079518482012-03-18T14:35:26.428+07:002012-03-18T14:35:26.428+07:00Alergic reaction with contrast are due to histamin...Alergic reaction with contrast are due to histamin release from the mast cells and basophil cells. So, the pre-medication and treatment should include H1 and H2 blockers + shortacting or long acting steroids is the treatment of choice.<br /><br />Dr Sushma Saroa,<br />Anaesthesiologist,<br />Department of Radiology,<br />Sir Ganga Ram Hospital(SGRH)DR SUSHMA SAROAnoreply@blogger.comtag:blogger.com,1999:blog-4841322830021321680.post-56671172168736757382011-02-16T21:16:58.730+07:002011-02-16T21:16:58.730+07:00It's been the little secret of radiology that ...It's been the little secret of radiology that these pre-treatment regimens are essentially useless, as 1) The likelihood of a second contrast reaction is 8%-25% (this doesn't even address the fact that these reactions may have more to do with stress/anxiety) and 2) Steroid pre-treatment may only be effective for minor reactions (does not protect against severe reactions). This is useless medical treatment at best and dangerous at its worst, because it gives a false sense of security. <br /><br />It persists, however, for medicolegal reasons: "Doctor, you knew the patient was at a higher risk for a contrast reaction, and you didn't adhere to the standard of care?" will say the friendly lawyer. Another reason we residents love it is because the standard 13-hour treatment pushes the study onto someone else's shift :)<br /><br />The ED literature has woken up to this (see Schabelman E, Witting M. The relationship of radiocontrast, iodine, and seafood allergies: a medical myth exposed. J Emerg Med. 2010 Nov;39(5):701-7.). They recommend: "Do not delay emergent studies for steroid premedication. Only lengthy 12-h premedication protocols have shown any effect on reaction rates, and this small benefit was manifested primarily by decreasing minor reactions. No steroid protocol has shown a significant benefit in decreasing severe or fatal reactions."Behrang Amini, MD/PhDhttps://www.blogger.com/profile/03079938131376181099noreply@blogger.com