Richtlijnen veilig gebruik van contrastmiddelen / Guidelines on Safe Use of Contrast Media

Richtlijnen Veilig Gebruik van Contrastmiddelen

Onder voorzitterschap van dhr. A.J. van der Molen, wordt door de NVvR een reeks nieuwe richtlijnen rondom Veilig Gebruik van Contrastmiddelen binnen de radiologie ontwikkeld. Deel 1 is geautoriseerd in 2017; deel 2 in november 2019. In 2020 wordt een start gemaakt met de ontwikkeling van deel 3. Zie voor de inhoud van de richtlijnen onderstaande links en toelichting.

Richtlijn deel 1
Richtlijn Veilig Gebruik van Contrastmiddelen (Engels met Nederlandse samenvatting) - Deel 1, 2017
Nederlandse samenvatting Aanbevelingen Richtlijn Veilig Gebruik van Contrastmiddelen - Deel 1, 2017

Richtlijn deel 2
Richtlijn Veilig Gebruik van Contrastmiddelen (Engels) - Deel 2 v07112019
Nederlandse samenvatting Aanbevelingen Richtlijn Veilig Gebruik van Contrastmiddelen - Deel 2 v07112019

Guidelines on Safe Use of Contrast Media

The NVvR deemed a set of new guidelines on the Safe Use of Contrast Media highly necessary and relevant, due to new publications and insights on topics concerning contrast safety. The patient population addressed are adults (>18 years) who receive intravascular, oral or intracavitary (intra-articular, intra-vesical, intra-cholangiographic) iodine-containing contrast media in a clinical or outpatient setting. The guidelines do not cover radioactive contrast media use in nuclear medicine. The three parts of the guidelines cover different topics regarding contrast media safety.

Guideline part 1 (published 2017)
- prevention of post-contrast acute kidney injury (PC-AKI) from iodine-containing contrast media;
- iodine-containing contrast media use in patients with type-2 diabetes taking metformin;
- iodine-containing contrast media use in patients on chronic dialysis.

links:​
Guideline Safe Use of Contrast Media (full English) - Part 1, 2017
Appendices Safe Use of Contrast Media (full English) - Part 1, 2017
Summary Recommendations Guideline Safe Use of Contrast Media (full English) - Part 1, 2017

Guideline part 2 (published 2019)
- management of hypersensitivity reactions to contrast media;
- prophylaxis of hypersensitivity reactions to contrast media & the role of skin testing in patients with hypersensitivity reactions;
- contrast media injections with power injectors through (peripherally inserted) central venous lines and implantable ports;
- contrast media extravasation;
- nephrotoxicity of gadolinium-based contrast agents;
- prevention of nephrogenic systemic fibrosis (NSF);
- retention of gadolinium in the body after use of gadolinium-based contrast agents.

links:
Guideline Safe Use of Contrast Media (full English) - Part 2, v07112019
Appendices Safe Use of Contrast Media (full English) - Part 2, v07112019
Flowcharts Safe Use of Contrast Media (full English) - Part 2, v07112019
Summary Recommendations Guideline Safe Use of Contrast Media (English) - Part 2, 07112019 

Guideline part 3 (in development >2020)
- prevention of iodine-induced hyperthyroidism;
- safety of organ-specific gadolinium-based contrast agents;
- contrast media use in pregnancy and during lactation;
- contrast media use in patients with pheochromocytoma;
- contrast media use in patients with myasthenia gravis;
- contrast media use in patients with mastocytosis;
- the Weber and Lalli effects in using contrast media.