Reazioni avverse da mezzi di contrasto: Un modello di profilassi

Preventing adverse reactions to contrast media is important for diagnostic and therapeutic purposes in view of the severe complications which may ensue. However, prevention is difficult because of the need to identify persons at risk. Since 1998, we have used an interactive CD-ROM medicine model of questions which guide neuroradiologists in history-taking and the clinical search for possible risk factors, providing a probabilistic assessment of the patient's possible risk, relative prevention and specific treatment protocol in case of an adverse reaction. Out of 6420 persons administered contrast media in the last three years (15th June 1997-15th June 2000), 720 (11.2%) received preventive treatment against adverse reaction based on major risk (high probability of reaction). There were six adverse reactions, all mild (0.09%). No prevention had been administered since these cases had not been identified as at risk. Our findings show that preventive medical treatment can prevent a high number of adverse reactions to contrast media. Models identifying the probability of risk with relative preventive management were appropriate. Adopting a widely shared model with identification of a centre to co-ordinate data would consolidate these results in larger series and thereby enhance the safety and economic management of neuroradiological investigation.