Topical treatment of tissue damage due to extravasation of iodinated contrast using thermal compresses

Abstract

Objective: To study the effectiveness of the topical application of dry cold or dry hot compresses in the treatment of non-ionic iodinated contrast extravasation injury.

Methods: A multicenter, consecutive, non-probabilistic experimental clinical trial was carried out between June 2017 and September 2020. The study included patients with extravasation of non-ionic iodinated contrast, administered through an injector pump during a computed tomography procedure. In the experimental group, a dry heat pack was applied in the first hour of treatment followed by a dry cold pack; the control group received only the cold pack. The size of the extravasation, pain, details of contrast administration, anthropomorphic data and the patient's clinical history were recorded. Follow-up was carried out at 24h.

Results: 65 patients were included, of which 32 were treated with cold pack only and 33 with heat and cold. In those receiving heat treatment, 30 (90.9%) patients had complete resolution, while those with cold treatment only had complete resolution in 13 (40.6%); p<0.001 and odds ratio 14.6 (95% CI 3.7-58.1). With the initial application of dry heat, local inflammation improved by 1.2% more than in those with dry cold treatment only.

Conclusions: The application of dry heat during the first hour of treatment was more effective, by more than 50 percentage points, at diffusing contrast and modulating the inflammatory process.

Keywords: Extravasation of contrast media; Inflammation; Patient safety; Tissue damage; Vascular system injuries.