Radiologic Contrast Reactions and Transfusion Reactions: Recognition, Differentiation, and Treatment

Abstract Acutely ill patients receive many treatments, some of which can cause serious reactions. It is not unusual for a critically ill patient to receive blood products and low osmolar nonionic iodine-based contrast material in close proximity to one another. If the patient appears to develop a reaction during the administration of either iodine-based contrast or transfusion, it may be difficult to determine whether the patient is experiencing a transfusion reaction or a contrast reaction. This article explores different types of acute reactions resulting from administration of blood products or iodine-based contrast and how to differentiate between these reactions. Only iodine-based contrast reactions and acute transfusion reactions are discussed, as these are by far the most common and most serious types of reactions that will occur. Bedside management of both types of reactions is also explored. In conclusion, timely recognition of acute transfusion and iodine-based reactions, along with an understanding of the differences and similarities between these reactions, enables the clinical team to appropriately evaluate and treat the patient for these potentially life-threatening events.