Reações de hipersensibilidade aos meios de contraste: avaliação do conhecimento de médicos do estado do Pará

Abstract

Contrast media have been widely used since the 1950s to facilitate diagnostic imaging. Doctors in almost all specialties prescribe, administer or care for patients who have received some contrast medium. These differ in their chemical structure, applicability and adverse effects. Therefore, physicians should be minimally familiar with the pharmacology, administration, risks and adverse reactions associated with these agents. However, despite the emergence of evidence-based medicine, gaps in knowledge are still filled by tradition, experiences and “common sense”, giving rise to misunderstandings with the spread of myths. In this sense, this dissertation intends to evaluate the knowledge of physicians working in the state of Pará regarding adverse reactions to contrast media. Thus, an observational, analytical and cross-sectional study involving 48 physicians from different specialties, using a virtual questionnaire addressing prophylaxis, risk factors and conduct related to the development of adverse reactions to contrast media. The data were organized using Microsoft Excel® and afterwards, Cronbach's alpha and descriptive statistical analysis were performed, with a consistent answer of 0.700. The graphic analysis was performed in R and RStudio. The results indicated that all physicians agree that it is essential to question the patient's allergic history prior to the use of contrast, and 90% of them agree to question about iodine allergy. Before releasing any contrasted test, 75% request an allergist assessment when there is a history of allergy to seafood / iodine, and 86% agree that patients allergic to iodine are at increased risk for reactions to contrasts. And most doctors (86%) indicate pre-medication in those with a history of previous reaction to contrasts. It was concluded that the notion of allergies to seafood and, especially to iodine as significant risk factors for adverse reactions to contrast media, remains widespread. The act of inquiring about these allergic conditions before requesting imaging tests, as well as recurring indication of premedication may induce the idea that these situations are a potential risk to allergic reactions to contrast media, thus propagating the myth. Medical education is vital to stop the persistence of these mistakes.