Contrast media reactions and extravasation: relationship to intravenous injection rates.

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Abstract
To evaluate the belief that the frequencies of contrast material extravasation and minor, nonidiosyncratic contrast material reactions correlate with intravenous injection rates. Complications of 6,660 consecutive injections of contrast material for computed tomography were prospectively recorded. Ionic (n = 4,851) or nonionic (n = 1,809) contrast material was injected at 0.5-4.0 mL/sec. The injection rate was 1.9 mL/sec or less in group 1 (n = 2,899), 2.0-2.9 mL/sec in group 2 (n = 2,475), and 3.0-4.0 mL/sec in group 3 (n = 1,286). The extravasation rate (0.6%) did not differ significantly between the groups. The reaction rate (8.4%) also did not differ significantly between the groups. The rate of minor reactions (8.0%) was higher with ionic (9.9%) than nonionic (2.9%) contrast material (relative risk = 3.4). The rate of major reactions (0.4%) did not vary significantly with type of contrast material. The rate of nausea or vomiting (3.8%) did not differ significantly between the groups but was higher with ionic (4.9%) than nonionic (1.1%) contrast material (relative risk = 4.5). The rate of severe warmth (2.1%) was significantly higher in group 3 (2.8%) than group 1 (2.0%) or 2 (1.8%). No correlations exist between injection rate and extravasation rate or overall reaction rate.

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