SEVERE HYPOTENSIVE COLLAPSE FOLLOWING THE USE OF LOW-OSMOLALITY CONTRAST-MEDIUM

Background. - Low osmolality contrast media are generally better toler ated than those with high osmolality. This report describes a case of severe collapse after injecting a low osmolality contrast medium. Case report. - A 15 month-old girl with aortic arch abnormalities was admi tted for investigation under general anesthesia. She had a history of allergy but had not previously been exposed to contrast medium. She wa s given ioxaglate (2 mg/kg) into an artery. The infusion immediately r esulted in generalized erythema, tachycardia, hypotensive collapse and ECG abnormalies. The patient was immediately given adrenaline, vasopr essive drugs, corticosteroids and plasma protein fraction, which led t o a rapid recovery. The ductus arteriosus was ligated a few days later without complications despite the application of iodine to the skin a nd the use of anesthetic drugs. Conclusion. - An unpredictable adverse reaction to low osmolality contrast medium can occur. Risk factors mu st be identified and immediate arrangements made for resuscitation.