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

OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

Manejo de las extravasaciones de contraste yodado, mediante una intervención térmica. Prueba piloto / Management of iodate contrast extravasations, through a thermal intervention. Pilot test

Objetivo. Analizar la eficacia de la aplicación del calor seco y del frío seco para la resolución de las extravasaciones de contraste yodado administrado mediante una bomba inyectora. Método. Estudio experimental. Se ha realizado una prueba piloto, para de-finir el protocolo de actuación y recogida de datos de un estudio comparativo multicéntrico. Se han evaluado 6 casos de extravasación recogidos en el periodo de marzo a junio de 2017, aplicando de forma aleatoria seco o calor seco como primera intervención. Resultados. En todos los casos se produjo una reacción inflamatoria generalizada de la extremidad afectada pasadas 24h. En los casos tratados con frío seco se pudo delimitar y medir la extravasación tras este intervalo de tiempo, sin embargo en los casos tratados con calor seco como primera intervención no se pudieron definir los contornos pasadas estas 24h. El dolor remitió de forma similar con ambas intervenciones. Conclusiones. La ausencia de con-torno definido y medible de la extravasación pasadas 24h, en las que fueron tratadas con calor seco como primera intervención, puede ser con-secuencia de una mejor absorción y distribución del contraste extravasado comparado con el frío seco. Lo que podría determinar que el calor seco es una intervención térmica positiva para la resolución de éstas ex-travasaciones

Objective. To analyse the efficacy of the application of dry heat and dry cold for the resolution of iodinated contrast extravasations administered by means of an injection pump. Method. Experimental study. A pilot test has been carried out to define the protocol for action and data collection of a comparative multicentre study. We have evaluated six cases of extravasation that occurred during the period of March to June 2017, randomly applying dry cold or dry heat as the first intervention. Results. In all cases, there was a generalized inflammatory reaction of the affected limb after 24h. In the cases treated with dry cold, it was possible to delimit and measure the extravasation after this time interval, however in the cases treated with dry heat as the first intervention, the contours could not be defined after these 24h. Pain returned similarly with both interventions. Conclusions. The absence of a defined and measurable contour of the extravasation after 24h, in which they were treated with dry heat as the first intervention, may be a consequence of a better absorption and distribution of extravasated contrast compared to dry cold. What could determine that dry heat is a positive thermal intervention for the resolution of these extravasations