Optimizing the Use of Iodinated Contrast Media: Conservation Strategies Used Across Canada During the 2022 Shortage

None CADTH
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 A shortage of iodinated contrast media (ICM) used in contrast-enhanced CT exams led to the adoption of necessary conservation strategies across Canada.
 Conservation strategies included multidispensing from single-use and multiuse ICM bottles, diluting or reducing ICM dose volumes, switching to weight-based dosing from fixed-based dosing, lower tube voltage, performing unenhanced CT scans, using alternative imaging modalities, or prioritizing urgent cases. One of the more common alternative conservation strategies was to prioritize urgent cases for contrast-enhanced CT exams.
 Most medical imaging staff who responded to a national survey on ICM conservation strategies reported they would return to their regular doses used before the shortage despite little to no perceived effect on the contrast conspicuity of images or on patient adverse events with reduced ICM volumes.
 The ICM shortage represents an opportunity to reconsider ICM usage practices given environmental sustainability concerns with ICM and potential cost savings in reducing its use.
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Abstract

A shortage of iodinated contrast media (ICM) used in contrast-enhanced CT exams led to the adoption of necessary conservation strategies across Canada. Conservation strategies included multidispensing from single-use and multiuse ICM bottles, diluting or reducing ICM dose volumes, switching to weight-based dosing from fixed-based dosing, lower tube voltage, performing unenhanced CT scans, using alternative imaging modalities, or prioritizing urgent cases. One of the more common alternative conservation strategies was to prioritize urgent cases for contrast-enhanced CT exams. Most medical imaging staff who responded to a national survey on ICM conservation strategies reported they would return to their regular doses used before the shortage despite little to no perceived effect on the contrast conspicuity of images or on patient adverse events with reduced ICM volumes. The ICM shortage represents an opportunity to reconsider ICM usage practices given environmental sustainability concerns with ICM and potential cost savings in reducing its use.
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优化碘造影剂的使用:在2022年短缺期间在加拿大使用的保护策略
& # x0D;对比增强CT检查中使用的碘造影剂(ICM)短缺,导致加拿大各地采取了必要的保护策略。 节约策略包括从一次性和多用途ICM瓶中多次分配,稀释或减少ICM剂量体积,从固定剂量改为体重剂量,降低管电压,进行非增强CT扫描,使用替代成像方式,或优先处理紧急病例。一种更常见的替代保护策略是优先考虑紧急病例进行对比增强CT检查。在一项关于ICM保存策略的全国调查中,大多数医疗成像人员表示,尽管ICM体积减少对图像的对比度显著性或患者不良事件的影响很小或没有感知到,但他们将恢复到短缺之前使用的常规剂量。考虑到ICM的环境可持续性问题以及减少ICM使用可能节省的成本,ICM短缺代表了一个重新考虑ICM使用实践的机会。
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