Review article: Effects of radiographic contrast media on the lung

The British Journal of Radiology
S K Morcos

Abstract

The pulmonary adverse effects of intravascular use of water soluble radiographic contrast media (RCM) include bronchospasm, pulmonary oedema and increase in the pulmonary arterial blood pressure (Ppa). Symptomatic bronchospasm is rare but subclinical increase in airways resistance is common after intravascular injection of RCM. Experimental studies have demonstrated that the low osmolar ionic dimer ioxaglate can induce significant bronchospasm in comparison with other types of RCM. Histamine and endothelin, which are potent bronchoconstrictors and released in response to the administration of RCM, do not seem to mediate the bronchospastic effect of RCM. Pretreatment with corticosteroids or antihistamine does not appear to prevent RCM induced bronchospasm, but the administration of beta(2) adrenergic agonist can abolish this adverse effect. RCM induced pulmonary oedema can be secondary to endothelial injury causing an increase in the permeability of the microcirculation. It may also occur in patients with incipient cardiac failure, when large doses of RCM particularly of the high osmolar type are used. A rise in Ppa induced by RCM seems to be secondary to an increase in pulmonary vascular resistance through direct effects on the...Continue Reading

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Citations

Feb 24, 2010·Medical Physics·Cristian T BadeaG Allan Johnson
Jan 6, 2006·European Radiology·Peter AspelinUNKNOWN Members of the Contrast Media Safety Committee of the European Society of Urogenital Radiology (ESUR)
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Sep 11, 2013·Surgical Endoscopy·Geoffrey Paul KohnUNKNOWN SAGES Guidelines Committee
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Dec 11, 2020·BMJ Case Reports·Genta NagaoKoichi Fukunaga

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