TY - JOUR
T1 - Patient Comfort During Contrast Media Injection in Coronary Computed Tomographic Angiography Using Varying Contrast Media Concentrations and Flow Rates Results From the EICAR Trial
AU - Kok, Madeleine
AU - Mihl, Casper
AU - Hendriks, Babs M. F.
AU - Altintas, Sibel
AU - Eijsvoogel, Nienke G.
AU - Kietselaer, Bas L. J. H.
AU - Wildberger, Joachim E.
AU - Das, Marco
PY - 2016/12
Y1 - 2016/12
N2 - Purpose: Pain sensation and extravasation are potential drawbacks of contrast media (CM) injection during computed tomographic angiography. The purpose was to evaluate safety and patient comfort of higher flow rates in different CM protocols during coronary computed tomographic angiography. Methods: Two hundred consecutive patients of a double-blind randomized controlled trial (NCT02462044) were analyzed. Patients were randomized to receive 94 mL of prewarmed iopromide 240 mg I/mL at 8.3 mL/s (group I), 75 mL of 300 mg I/mL at 6.7 mL/s (group II), or 61 mL of 370 mg I/mL at 5.4 mL/s (group III), respectively. Iodine delivery rate (2.0 g I/s) and total iodine load (22.5 g I) were kept identical. Outcome was defined as intravascular enhancement, patient comfort during injection, and injection safety, expressed as the occurrence of extravasation. Patients completed a questionnaire for comfort, pain, and stress during CM injection. Comfort was graded using a 5-point scale, 1 representing "very bad" and 5 "very well." Pain was graded using a 10-point scale, 0 representing "no pain" and 10 "severe pain." Stress was graded using a 5-point scale, 1 representing "no stress" and 5 "unsustainable stress." Results: Mean enhancement levels within the coronary arteries were as follows: 437 +/- 104 Hounsfield units (HU) (group I), 448 +/- 111 HU (group II), and 447 +/- 106 HU (group III), with P >= 0.18. Extravasation occurred in none of the patients. Median (interquartile range) for comfort, pain, and stress was, respectively, 4 (4-5), 0 (0-0), and 1 (1-2), with P >= 0.68. Conclusions: 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.
AB - Purpose: Pain sensation and extravasation are potential drawbacks of contrast media (CM) injection during computed tomographic angiography. The purpose was to evaluate safety and patient comfort of higher flow rates in different CM protocols during coronary computed tomographic angiography. Methods: Two hundred consecutive patients of a double-blind randomized controlled trial (NCT02462044) were analyzed. Patients were randomized to receive 94 mL of prewarmed iopromide 240 mg I/mL at 8.3 mL/s (group I), 75 mL of 300 mg I/mL at 6.7 mL/s (group II), or 61 mL of 370 mg I/mL at 5.4 mL/s (group III), respectively. Iodine delivery rate (2.0 g I/s) and total iodine load (22.5 g I) were kept identical. Outcome was defined as intravascular enhancement, patient comfort during injection, and injection safety, expressed as the occurrence of extravasation. Patients completed a questionnaire for comfort, pain, and stress during CM injection. Comfort was graded using a 5-point scale, 1 representing "very bad" and 5 "very well." Pain was graded using a 10-point scale, 0 representing "no pain" and 10 "severe pain." Stress was graded using a 5-point scale, 1 representing "no stress" and 5 "unsustainable stress." Results: Mean enhancement levels within the coronary arteries were as follows: 437 +/- 104 Hounsfield units (HU) (group I), 448 +/- 111 HU (group II), and 447 +/- 106 HU (group III), with P >= 0.18. Extravasation occurred in none of the patients. Median (interquartile range) for comfort, pain, and stress was, respectively, 4 (4-5), 0 (0-0), and 1 (1-2), with P >= 0.68. Conclusions: 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.
KW - multidetector computed tomography
KW - coronary vessels
KW - flow injection analysis
KW - contrast media extravasation
U2 - 10.1097/RLI.0000000000000284
DO - 10.1097/RLI.0000000000000284
M3 - Article
C2 - 27164459
SN - 0020-9996
VL - 51
SP - 810
EP - 815
JO - Investigative Radiology
JF - Investigative Radiology
IS - 12
ER -