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題 名 | Acute Non-cardiogenic Pulmonary Edema Associated with the Radiographic Contrast Medium Ioversol=顯影劑Ioversol相關之急性非心源性肺水腫 |
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作 者 | 許宏達; 林志明; 蔡宗諺; 周紹賓; 孫宗伯; | 書刊名 | 慈濟醫學 |
卷 期 | 17:4 民94.08 |
頁 次 | 頁273-277+301 |
分類號 | 418.346 |
關鍵詞 | 顯影劑; 肺水腫; 血管造影; 不良反應; Contrast medium; Pulmonary edema; Ioversol; Angiography; Adverse effect; |
語 文 | 英文(English) |
中文摘要 | Ioversol是一種含碘、低滲透壓、非離子性的血管造影顯影劑。靜脈注射顯影劑導致危及生命的非心源性肺水腫十分罕見,至今尚未有因Ioversol造成急性肺水腫的相關報告。我們提出一65歲的糖尿病合併週邊動脈阻塞性疾病的女性病患,當他接受125 mL Ioversol靜脈注射以進行雙側下肢血管造影時,產生冒冷汗、意識喪失、呼吸困難等症狀,緊急胸部X光顯示急性肺水腫之變化。經立刻氣管插管及於加護病房接受呼吸器輔器治療,肺水腫之症狀於72小時內得到完全緩解。經查閱英文文獻得知,與顯影劑相關之嚴重危又生命的不良反應發生率極低,本例當為Ioversol造成非心源性急性水腫的首例報告,適時的鑑別診斷、積極的呼吸治療、避免病患脫水為搶救病患生命之要點。 |
英文摘要 | Ioversol is an iodinated, low-osmolality, nonionic contrast agent used in angiography. Life threatening non-cardiogenic pulmonary edema after intravenous administration of radiographic contrast medium is a rare event. We could find no report of ioversol-related pulmonary edema. We present a case of 65-year-old woman with diabetes mellitus and peripheral arterial occlusive disease who underwent angiography for evaluation of both lower limbs. Cold sweating, dyspnea, and lost of consciousness were noticed soon after 125 mL of ioversol injection. She was intubated immediately and chest radiograph showed severe pulmonary edema. After intensive mechanical ventilatory support, she recovered and was extubated 72 hours after the anaphylactic episode. Reports in the English literature show that severe, life-threatening, adverse effects associated with radiographic contrast medium are rare. Our presenting case may be the first associated with the specific radiocontrast ioveraol. Prompt differential diagnosis, aggressive ventilatory support, and avoid dehydration are essential to prevent a fatal outcome. |
本系統中英文摘要資訊取自各篇刊載內容。