Radiologic Contrast Media Desensitization for Delayed Cardiac Catheterization

• Published in: Allergy & rhinology (Providence, R.I.) R.I.), 2019-12, Vol.10, p.2152656719892844
• Main Authors: Sanan, Neha, Rowane, Marija, Hostoffer, Robert
• Format: Article
• Language: English
• Subjects: Allergens; Anaphylactoid reactions; Cardiac catheterization; Case Report; Catheterization; Contrast media; Dosage; Heart; Intravenous administration; Intubation; Nephropathy
• ISSN: 2152-6567; 2152-6575; 2152-6567
• DOI: 10.1177/2152656719892844

This protocol for rapid desensitization to intravenous radiographic contrast material (RCM) improves the strategy first reported by Uppal et al. Desensitization is a validated preventative measure for medical emergencies, such as cardiac catheterization, when patients present with histories of anaphylactoid reactions to the allergen of concern. The patient required another catheterization that was modified to repeat the final dosage of 320 mg/mL of Visipaque®, accommodating cardiac catheterization postponement, contrary to readministration of doses 4 (0.625 mg/mL) and 8 (10 mg/mL) as reported in Uppal et al. Our risk score calculations suggested that the patient was at low risk of contrast-induced nephropathy (CIN) that did not necessitate reduced dosage. No complications were reported following catheterization. We propose repetition of the final RCM dosage as a more effective and efficient desensitization strategy, as long as the scoring system does not indicate high risk for CIN.