Topical treatment of tissue damage due to extravasation of iodinated contrast using thermal compresses

Abstract

To study the effectiveness of the topical application of dry cold or dry hot compresses in the treatment of non-ionic iodinated contrast extravasation injury. A multicenter, consecutive, non-probabilistic experimental clinical trial was carried out between June 2017 and September 2020. The study included patients with extravasation of non-ionic iodinated contrast, administered through an injector pump during a computed tomography procedure. In the experimental group, a dry heat pack was applied in the first hour of treatment followed by a dry cold pack; the control group received only the cold pack. The size of the extravasation, pain, details of contrast administration, anthropomorphic data and the patient's clinical history were recorded. Follow-up was carried out at 24h. 65 patients were included, of which 32 were treated with cold pack only and 33 with heat and cold. In those receiving heat treatment, 30 (90.9%) patients had complete resolution, while those with cold treatment only had complete resolution in 13 (40.6%); p<0.001 and odds ratio 14.6 (95% CI 3.7-58.1). With the initial application of dry heat, local inflammation improved by 1.2% more than in those with dry cold treatment only. The application of dry heat during the first hour of treatment was more effective, by more than 50 percentage points, at diffusing contrast and modulating the inflammatory process.