Mp. Federle et al., IONIC VERSUS NONIONIC CONTRAST-MEDIA - A PROSPECTIVE-STUDY OF THE EFFECT OF RAPID BOLUS INJECTION ON NAUSEA AND ANAPHYLACTOID REACTIONS, Journal of computer assisted tomography, 22(3), 1998, pp. 341-345
Purpose: The purpose of our study was to evaluate the effect of bolus
infusion of contrast medium (ionic versus nonionic) on the incidence o
f nausea and anaphylactoid reactions. Method: We prospectively studied
1,827 patients who had bolus enhanced body CT scans and divided them
into four groups: 725 patients received higher osmolality contrast med
ium (HOCM) at the slower bolus rate of 1-2.5 mils (SLOW-HOCM group); 6
50 patients were in the FAST-HOCM group and received the same ionic co
ntrast medium at 4-5 ml/s; 250 patients received lower osmolality cont
rast medium (LOCM) at 1-2.5 ml/s, forming the SLOW-LOCM group; and 202
patients in the FAST-LOCM group got the same nonionic agent at 4-5 ml
/s. Results: We found no significant difference in the rate of nausea
among the first three groups: SLOW-HOCM (3.9%), FAST-HOCM (4.9%), and
SLOW-LOCM (3.2%). A statistically significant lower incidence of nause
a (0.5%) was found in the FAST-LOCM group. Anaphylactoid reactions wer
e significantly more common in both groups who received HOCM (8.3 and
9.1%) compared with the groups who received LOCM (2.0 and 2.5%). Concl
usion: The bolus injection of warmed ionic contrast medium at a rate o
f 1-2.5 ml/s causes no significant increase in nausea compared with si
milar infusion rates of nonionic agents. For CT protocols that require
infusion rates of 4-5 ml/s, the use of a nonionic agent is associated
with a significantly reduced prevalence of nausea. The prevalence of
anaphylactoid reactions is not affected by the rate of injection.