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Biphasic and protracted anaphylaxis to iodinated contrast media.
- Source :
-
European Radiology . Mar2018, Vol. 28 Issue 3, p1242-1252. 11p. 1 Diagram, 5 Charts, 1 Graph. - Publication Year :
- 2018
-
Abstract
- <bold>Objectives: </bold>To investigate the prevalence of biphasic and protracted anaphylaxis to iodinated contrast media (ICM), their risk factors and practical observation duration for detecting biphasic reaction.<bold>Methods: </bold>145 patients with ICM anaphylaxis from January 2005-February 2016 were retrospectively categorised into uniphasic, biphasic (anaphylaxis recurrence within 72 h after resolution of initial anaphylaxis) and protracted (anaphylaxis >5 h) reaction groups. Multivariate regression analyses of potential risk factors were performed. We calculated negative predictive value (NPV) for biphasic reactions and additional person-hours required to detect one case during post-anaphylaxis observation.<bold>Results: </bold>Fifteen patients had biphasic reactions with secondary reactions with similar or milder severity and six had protracted reactions. Most significant risk factors were anaphylaxis duration >40 min for biphasic reactions (odds ratio (OR), 8.65 [95 % CI, 1.05-70.71]; P=0.044), and additional epinephrine administration within 1 h of initial dosing for protracted reactions (OR, 102.0 [95 % CI, 3.40-3057.25]; P=0.008). A 6-h post-anaphylaxis observation produced NPV of 96.4 %, while requiring a minimum of 65.5 additional person-hours to detect one additional case.<bold>Conclusion: </bold>Biphasic and protracted ICM anaphylaxis developed in 10.3 % and 4.1 %, respectively, with revealing risk factors. Six hours could be practical for post-anaphylaxis observation to detect biphasic reaction.<bold>Key Points: </bold>• Incidence of biphasic anaphylaxis in iodinated contrast media anaphylaxis is 10.3 %. • Incidence of protracted anaphylaxis in iodinated contrast media anaphylaxis is 4.1 %. • Initial anaphylaxis >40 min can predict for biphasic anaphylaxis development. • A 6-h post-anaphylactic observation in ICM-related anaphylaxis seems practical. [ABSTRACT FROM AUTHOR]
- Subjects :
- *ANAPHYLAXIS
*RADIOLOGY
*DRUG side effects
*EPIDEMIOLOGY
*ANTI-inflammatory agents
Subjects
Details
- Language :
- English
- ISSN :
- 09387994
- Volume :
- 28
- Issue :
- 3
- Database :
- Academic Search Index
- Journal :
- European Radiology
- Publication Type :
- Academic Journal
- Accession number :
- 127990351
- Full Text :
- https://doi.org/10.1007/s00330-017-5052-0