Would you like to know how to mitigate this? Apparently, a lot of researchers and doctors still don’t know how to use CT contrast, despite better practices coming out years ago. I can vouch for this in a local hospital, where I got the practices permanently changed.
It appears the main problem with CT contrast is that the viscosity (thickness) is above the safe zone, according to prior published, and trained, information. This seems to create what one writeup once called “micro-tears” in sensitive tissues, like the kidneys, leading to part of what is then called a “contrast allergy.” Additionally, as the next post will show, we can’t be allergic to iodine, but can be to the rest of the compound(s) in the specific contrast.
Pharmacists should have been trained on this, but CT techs and doctors, haven’t, seemingly.
I’ll next post the PowerPoint slides from a 2016 pharmacist conference presentation that points to the problem and the practices to prevent it. In sum, it is making sure your CT tech is pre-heating the contrast to body temperature, reducing viscosity by 50%, if using a higher concentration (such as with chest or brain scans), and using a better contrast agent option (use a low-osmolality contrast agent like Isovue, Optiray, or Omnipaque).
Do note I am not a doctor, but I can read and pass on what makes sense, to me, from what doctors and researchers provide.
“Best Practices in the Use of Iodinated Contrast Media in the Clinical Setting: What the Pharmacist Needs to Know” (February 2016)
https://ashpadvantagemedia.com/contrastmedia/files/handout-contrastmedia.pdf
My wife is allergic to contrast dye. When this first happened and her throat was closing up, the nurses ran around not prepared until a doctor finally came up with an antihistamine and luckily she could still swallow it.
No idea why they didn’t prepare for this.
Just ran into this problem myself. They wouldn’t use contrast because my gfr is 29 (it fell from 36 from a previous test result just a few months earlier- I had a test with contrast back then- then needed another due to another problem, but they said they couldn’t use it for the reason stated above)
Contrast wrecked my kidneys. Between 2013 and 2020, I had more than a dozen procedures.
My second cat scan triggered a shellfish allergy. It took me a year to figure out why it was “everybody out of the pool..... NOW” every time I ate shrimp, and then I discovered it by researching on the internet. When I asked my Dr he said “oh yeah, that happens sometimes”. Sheesh. Thanks a lot!
No thanks. I’m a kidney transplant recipient, and this little puppy has been on the brink of death more than once. I’d rather have a less accurate scan than wind up back on dialysis.
I also have bad reactions to iodine and betadine, so... No thanks.