Short-Term Mitigation Steps During the Iohexol Contrast Shortage: A Single Institution’s Approach

Scenario Planning Approach to Adapting in the COVID Era

“…Radiology has seen shortages of helium impacting MRI. The shutdown of the Shanghai contrast manufacturing plant during the 2022 summer due to a COVID lockdown resulted in a global reduction of iodinated contrast for over 2 months with extensive changes in clinical practice ( 32 , 33 ). Much of the supply chain issues are external to hospitals but they will impacted by them.…”

Metrics-driven successful strategy by emergency and radiology driven task force to mitigate global CT contrast media shortage in a safety net hospital

“…[13] Last but not least, we built at least 2 weeks of contrast reserves to provide optimal care for emergency department (ED) patients in case the shortage became protracted and while other strategies to acquire contrast while decreasing waste was put in place. [14][15][16] e task force designed a heat map to identify, prioritize, and assess the feasibility of the action steps. Impact scoring, as shown in [Figure 1], further aided the task force in focusing on high-value action items.…”

“…is further provided us to aggressively reduce the overall daily utilization across the enterprise by around 60-80% [Figure 2]. [5,14] Key strategic initiatives ey were identifying strategies that decreased contrast usage and addressing the high-impact factors initially was the key to navigate the ICM production shortage successfully. Our steps mirrored the strategic actions taken by multiple other institutions and are consistent with ACR recommendations with overarching goals of extending contrast supply run rate and reducing waste.…”

“…Identifying the clinical indications for ICM required input from ED, trauma, and inpatient services to develop alternative imaging studies. [11,14] In our institution, noncontrast CT examinations were quickly adapted substituted when applicable, resulting in a significant drop in contrast ultrasound. [19] For instance, magnetic resonance angiography (MRA) can be substituted for CTA in patients with suspected aortic dissection or pulmonary embolism with stable hemodynamics.…”

Can gadolinium be used as an alternative to iodinated contrast for CT angiography during the current pandemic-related contrast shortage?

“…A large General Electric facility in Shanghai discontinued manufacture of a water-soluble iodine contrast Omnipaque (iohexol) in April 2022. This has resulted in a significant supply chain disruption of one of the most widely used low-osmolality contrast agents in the diagnostic and interventional radiology field [1]. Although production has now resumed, iodinated contrast is likely to remain scarce until at least July 2022 and due to this shortage, many non-emergency tests are being postponed [2].…”