Acute Pulmonary Edema of Non-Cardiac Origin Causing Cardiopulmonary Arrest Following Injection of Non-Ionic Intravenous Computed Tomography Scan Contrast: A Case Report and Brief Review

Abstract

Non-cardiac pulmonary edema following intravenous (IV) contrast medium is a rare form of severe allergic response; however, association of cardiopulmonary arrest with it is even an extremely uncommon occurrence. It is a very serious and life threatening reaction, and it must be immediately recognized and promptly treated to avoid poor outcome. I, report a case of a 77-year-old female who developed an immediate acute pulmonary edema of non-cardiac origin resulting in cardiopulmonary arrest on computed tomography (CT) scan table following IV non-ionic contrast media injection of Optiray 320 during spiral CT of abdomen for a routine outpatient urological disorder for follow-up with a miraculous outcome. There was no known previous reaction or allergy to IV contrast. A prolonged cardiopulmonary resuscitation (CPR) more than 4 h was required to revive and stabilize the patient’s critical condition with complete recovery without any sequel. Take home message is to be familiar with and recognize these catastrophic complications of IV contrast and be prepared to manage them appropriately and immediately to save the patients’ life. A routine use of IV Benadryl prior to contrast injection may be beneficial in high risk patients. Due to serious untoward reactions of IV contrast, it may be prudent to discover or invent a new inert substance or improved CT scanning techniques without any contrast. “Thou shall not harm”. J Med Cases. 2018;9(1):5-7 doi: https://doi.org/10.14740/jmc2955e