KM-Allergie und ERCP: Prophylaxe notwendig?

Zusammenfassung

Allergische Reaktionen nach intravasaler jodierter Kontrastmittelinjektion sind häufig, prophylaktische Therapieregime etabliert. Obgleich die systemische Resorption von Kontrastmittel während der ERCP gut dokumentiert ist, erscheint die Inzidenz einer Kontrastmittelallergie verschwindend gering oder überhaupt nicht vorhanden. Aus dieser Situation heraus ist es auch nicht erstaunlich, dass keine standardisierten, evidenzbasierten Empfehlungen existieren oder erstellbar wären. Die übliche Praxis empfiehlt eine Prämedikation bei Risikopatienten, obgleich das wahrscheinlich, basierend auf einer Studie mit konsekutiven (Risiko-)Patienten, gar nicht notwendig ist.

Abstract

Adverse reaction after intravascular administration of iodine radio contrast media are common and prophylactic regiments are well established. Even though systemic adsorption of contrast media after ERCP routinely occurs, the incidence of adverse allergic events seems to be very low or not excisting. His low incidence explains the lack of formal evidence based recommendations.The standard practice recommends prophylaxis, even if data including patients at risk suggest that the use of prophylactic regiments appears to be unnecessary.

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