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首页> 外文期刊>Vascular and endovascular surgery >Successful Graded Dose Challenge to Iodixanol Radiocontrast Media in a Patient With Delayed Anaphylaxis to Iohexol
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Successful Graded Dose Challenge to Iodixanol Radiocontrast Media in a Patient With Delayed Anaphylaxis to Iohexol

机译：在患有延迟过敏的患者到碘己基的患者中成功评分剂量挑战

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摘要

We present a case of an 82-year-old male with known radiocontrast media (RCM) hypersensitivity who was admitted to our hospital with gangrene of his right toe. The plan for revascularization of his lower extremity required an angiogram. This presented a management challenge as the patient had experienced 2 episodes of delayed anaphylaxis to Omnipaque (iohexol) RCM, and based on a literature review, there was no known or established precedent on a safe procedure in these situations. The patient was premedicated and given a graded dose challenge of an alternative RCM (iodixanol) prior to the radiographic study. He was given 1% of the total expected dose 1 hour before to the procedure and an additional 10% for the 30 minutes prior. He was then given the final dose in the operating room. Following angiogram, the patient was monitored for 18 hours in the postanesthesia care unit, with no adverse reactions. He was placed on a prednisone taper for 1 week, with daily diphenhydramine. The patient remained asymptomatic throughout the hospital course. This novel approach to RCM hypersensitivity management lends itself to a hope that graded dose challenges may play a greater role in the management of these patients.
机译：我们提出了一个82岁的男性，具有已知的radioContrast媒体（RCM）超敏反应，他与他的权利脚趾生成的Gangrene录取。他的下肢血运重建计划需要血管造影。这提出了一种管理挑战，因为患者经历了2个延迟过敏性的延迟过敏（Iohexol）RCM，并且基于文献综述，在这些情况下没有任何已知或在安全程序中确定的先例。患者在放射线研究之前对替代RCM（Iodixanol）进行分级剂量挑战。他在前一小时前1％的预期剂量获得了1％，并在30分钟前额外10％。然后他在手术室里给了最后剂量。在血管造影之后，患者在麻醉护理单元中监测18小时，没有不良反应。他被置于泼尼松锥度1周，每日二酚胺。患者在整个医院课程中保持无症状。这种新颖的RCM超敏反应管理方法为希望在这些患者的管理中发挥更大的作用。

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