Patient Comfort During Contrast Media Injection in Coronary Computed Tomographic Angiography Using Varying Contrast Media Concentrations and Flow Rates

Abstract

High flow rates of prewarmed CM were safely injected without discomfort, pain, or stress. Therefore, the use of high flow rates should not be considered a drawback for CM administration in clinical practice.

Contrast Media Administration in Coronary Computed Tomography Angiography – A Systematic Review

“…In both in vivo and phantom studies, comparison of protocols using different CM concentrations (varying between 240 -400 mg/ml) established comparable intravascular enhancement patterns when the IDR and other CM-and scan-related factors were kept standardized. These findings are supported by a double-blind randomized controlled study, in which both the objective and the subjective image quality were evaluated with usage of different iodine concentrations (e. g. 240 mg/ml, 300 mg/ml and 370 mg/ml) while maintaining an identical IDR and total iodine load [78]. In addition, patient comfort and pain at the injection site with usage of flow rates varying 5.4 -8.3 ml/s and incidence of contrast extravasation have been evaluated.…”

“…In addition, patient comfort and pain at the injection site with usage of flow rates varying 5.4 -8.3 ml/s and incidence of contrast extravasation have been evaluated. No significant differences were found between groups regarding comfort, stress, and pain [78]. This study also shows that the reluctance towards the usage of higher flow rates as a possible cause for an increased incidence of extravasation due to increased injection pressures is merely based on hypothetical flow-related issues.…”

Contrast media extravasations in patients undergoing computerized tomography scanning: a systematic review and meta-analysis of risk factors and interventions

“…Among the citations that had data on the relevant outcomes, there was one randomized control trial, 37 one pseudo-randomized trial, 36 one quasi-experimental trial, 19 and one pre-post study, 31 with the remainder being cohort 9 , 23 , 26 , 27 , 28 , 34 , 40 , 42 or case series designs. 38 , 39 , 41 Studies other than clinical trials were included when they related to a different outcome, population of interest or intervention.…”

“…The population considered in one of them included both adults and children, 42 whereas the other studies concentrated on adults only. 19 , 23 , 26 , 28 , 37 The study of Schwab et al , 19 mentioned previously for catheter size, also considered the variable of “infusion rate”. The two variables cannot be separated since the infusions were either performed with a large cannula and a high flow rate or a small cannula and a low flow rate, therefore, the results of this study were not considered here again.…”

Amacing

“…52 Injection protocol parameters have been the subject of many optimisation studies, and many advances have been made. [52][53][54][55][56][57][58][59][60][61][62][63][64] Reductions in contrast volumes of up to 75% have been achieved using relatively low-iodine concentration contrast agents whilst maintaining sufficient diagnostic image quality.…”