Optiray / Ioversol causes death instantly or within minutes of being injected. This contrast injection should be pulled from being used. Throat swells, patient passes out because they can not breath and then patient goes into cardiac arrest and dies!
Received: 20 October 2006 / Accepted: 25 March 2007 / Published online: 8 June 2007 Springer Science+Business Media B.V. 2007 Abstract We report a fatal intravenous ioversol administration in a 60-year old male patient. Although the introduction of new low-osmolar non-ionogenic contrast media with a more favourable efficacy-toxicity balance has diminished the side-effects significantly, everyone involved in radiodiagnostic procedures should be aware of the potential life-threatening effects. Especially patients with risk factors for side-effects should be monitored carefully. Keywords Contrast media Anaphylactoid reaction Adverse effects Risk factors Introduction For several decades, organic iodinated contrast media have been used for diagnostic radiologic imaging purposes. Because of the absorption difference of X-rays by the iodine-molecule and surrounding tissues, radiographic visualisation of structures is possible. Although new compounds with a more favourable efficacy-toxicity balance have been introduced, severe and life-threatening side-effects are still reported. We present a male patient with a fatal cardiac arrest after intravenous ioversol administration. Case description A 60-year-old man, with a history of regulated diabetes mellitus type II and hypertension, was referred for an abdominal contrast-enhanced CT-scan, because of presurgical staging of a rectal carcinoma His medication consisted of metformin and a thiazide diuretic. There was no history of allergic reactions. After ioversol 350, 100 ml had been administered intravenously, the patient complained of headache and nausea. Subsequently, he lost consciousness with discoloration of his skin to red-purple. Immediate basic life support was started. On arrival of the medical emergency team, patient was found in pulseless electrical activity.During endotracheal intubation no signs of glottis edemawere noticed.Ventricular fibrillation developed for which (unsuccessful) external electrical defibrillation was performed. After 40 min of cardiopulmonary resuscitation with repeated doses of epinephrine, clemastine, atropine, and amiodarone, with concomitant dexamethasone, calcium, theophylline, transcutaneous pacing and intracardial epinephrine, the transthoracic echocardiogram yielded cardiac standstill without ventricular dilatation. It was then decided to cease resuscitation. An autopsy found, besides the rectal carcinoma without lymph node metastasis, benign adrenal and prostatic hyperplasia concentric left ventricular hypertrophy. Discussion Ioversol, used in the present case, is a low-osmolar nonionic monomeric contrast medium, with a relatively F. G. Jansman J. W. Harting Department of Clinical Pharmacy, Isala klinieken, Zwolle, The Netherlands F. G. Jansman (&) Department of Pharmacotherapy and Pharmaceutical Care, Groningen University Institute for Drug Exploration (GUIDE), Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands e-mail: [email protected] H. Kieft Department of Intensive Care, Isala klinieken, Zwolle, The Netherlands 123