Skin ulceration from extravasation of low-osmolality contrast medium: a complication of automation.

Contrast medium extravasation injury: guidelines for prevention and management

“…Conservative management is adequate in most cases Limb elevation Apply ice packs Careful monitoring If a serious injury is suspected, seek the advice of a surgeon osmolality threshold for significant tissue injury is estimated to be 1.025-1.420 mOsm/kg water [10,11,12,13]; however, four severe injuries have been reported with non-ionic contrast media, none of which required reconstructive surgery [14,15,16,17].…”

“…The fourth factor is the mechanical compression caused by large-volume extravasations that may lead to compartment syndromes [14,15,16,17]. Infection of the extravasated site may increase the severity of the injury.…”

“…Extravasation may also result in acute compartmental syndromes producing tense and dusky forearms, with swelling and diminished arterial pulses. Compartmental syndromes may necessitate emergency fasciotomy to relieve neurovascular compromise [14,15,16,17].…”

Lower limb compartment syndrome due to computer tomography contrast infiltration

“…The majority of reported cases have occurred with large-volume extravasations, 18 which may cause mechanical compression. 11,15,20 When evaluating skin reactions that occur with low-osmolar contrast agents, it appears the pathogenesis may be related to T-cell mediated reactions. The skin reactions often show features typical of late hypersensitivity including examthematous rash, positive skin tests, and lymphocyte rich dermal infiltrate with eosinophils.…”

Administración de contrastes intravenosos: las extravasaciones

“…Se ha comprobado en animales de experimentación que, cuanto más elevada es esta, mayor daño tisular provoca 13,14 . Sin embargo, existen casos documentados en los cuales se han producido lesiones severas con extravasaciones de contraste de baja osmolalidad 1,15 . El umbral de osmolalidad a partir del cual se produce daño tisular significativo es de 1.025-1.420 mOsm/Kg de agua 13,14 .…”