Stranski učinki pri uporabi jodovih kontrastnih sredstev v radiologiji : diplomsko delo

Jandrić, Dejan (avtor), Gruden, Tobija (avtor), Starc, Tina (mentor), Medič, Mojca (recenzent)

Uvod: V radiološki diagnostiki je vedno večja uporaba kontrastnih sredstev, med katerimi je najbolj uporabljeno jodovo. Kontrastna sredstva so snovi, ki se uporabljajo za razločevanje tarčnega tkiva z okolnim. Apliciramo jih lahko na različne načine med katerimi je najpogostejša intravenozna aplikacija, po kateri pa je tudi največja možnost za pojav stranskih učinkov. Namen: Namen diplomskega dela je predstaviti kontrastna sredstva s poudarkom na pojavu neželenih stranskih učinkov po aplikaciji jodovih kontrastnih sredstev. Cilj diplomskega dela pa je podrobno pregledati literaturo in predstaviti pojavnost stranskih učinkov, ugotoviti dejavnike tveganja za nastanek le teh, ter ugotoviti na kakšen način se lahko izognemo pojavu nefrotoksičnosti po aplikaciji jodovega kontrastnega sredstva. Metode dela: V diplomskem delu smo uporabili deskriptivno metodo dela s pregledom obstoječe literature s področja uporabe kontrastnih sredstev in pojavom stranskih učinkov v radiološki diagnostiki. Navedeno literaturo smo iskali od oktobra 2021 do aprila 2022 v podatkovnih bazah kot so Cobiss, RUL, Digitalna knjižnica Slovenije, DIKUL, Pub Med, Google učenjak, Science Direct, ter Radiopedija. V končno analizo smo vključili dostopna in recenzirana angleška ter slovenska besedila napisana med letoma 2000 in 2022, članke, ki opisujejo uporabo kontrastnih sredstev ter pojav stranski učinkov ob sami aplikaciji in članke z jasnim namenom ter rezultati. Rezultati: Ugotovili smo, da je pojavnost neželenih stranskih učinkov v primerjavi s številom opravljenih preiskav zelo majhna, pri čemer v veliki večini prevladujejo blage reakcij, sledijo jim zmerne, najmanj pa je hudih reakcij. Na pojavnost neželenih stranskih učinkov vplivajo tudi dejavniki tveganja kot so ženski spol, starost nad 60 let, raven SpO2, raven sistoličnega tlaka, hipertenzija, diabetes, srčno-žilne bolezni, ledvične okvare, predhodne alergijske reakcije in reakcije na KS ter astma. Nazadnje smo ugotovili tudi to, da lahko z različnimi načini vplivamo na preprečevanje nastanka nefrotoksičnosti. Razprava in zaključek: V Sloveniji primanjkuje raziskav na področju neželenih stranskih učinkov po aplikaciji kontrastnih sredstev, ki bi jih lahko primerjali s tujo literaturo in tako prišli do zaključkov glede incidence stranskih učinkov pri nas. Kljub temu pa so bili cilji diplomskega dela doseženi, saj smo ugotovili da diagnostični učinek kontrastnih sredstev pretehta pojavnost stranskih učinkov. Ob poznavanju rizičnih faktorjev pa lahko to pojavnost še zmanjšamo.

• Jezik: Slovenski jezik
• Ključne besede: diplomska dela, radiološka tehnologija, kontrastna sredstva, jodova kontrastna sredstva, stranski učinki, ukrepi, radiologija
• Vrsta gradiva: Diplomsko delo/naloga
• Tipologija: 2.11 - Diplomsko delo
• Organizacija: ZF - Zdravstvena fakulteta
• Kraj izida: Ljubljana
• Založnik: [D. Jandrić, T. Gruden]
• Leto izida: 2022
• Št. strani: 42 str.
• PID: 20.500.12556/RUL-140297
• UDK: 616-07
• COBISS.SI-ID: 121467395
• Datum objave v RUL: 14.09.2022

Sekundarni jezik

• Jezik: Angleški jezik
• Naslov: Adverse reactions to iodinated contrast media in radiology : diploma work

Izvleček

Introduction: There is an increase in useage of contrast agents in radiological diagnostics, among which iodine is the most widely used. Contrast agents are substances used to distinguish the target tissue from the surrouding. They can be administered in various ways, the most common is intravenous administration, after which there is also the biggest possibility of side effects. Purpose: The purpose of this thesis is to present contrast agents with emphasis on the occurrence of unwanted side effects after the application of iodine contrast agents. The aim of the thesis is to review the literature in detail and present the incidence of side effects, identify risk factors for their occurance, and determine how to avoid the occurance of nephrotoxicity after application of iodine contrast agent Methods: In this thesis we used a descriptive method of work with a review of the existing literature in the field of contrast agents and the occurance of side effects in radiological diagnostics. From October 2021 to April 2022, we searched for the mentioned literature in databases such as Cobiss, RUL, Digital Library of Slovenia, DIKUL, Pub Med, Google Scholar, Science Direct and Radiopedia. The final analysis included accessible and peer-reviewed English and Slovenian texts written between 2000 and 2022, articles describing the use of contrast agents and the occurance of side effects with the application itself, and articles with clear purpose and results. Results: We found that the incidence of adverse reactions was very low compared to the number of investigations performed, with the vast majority beeing dominated by mild reactions, followed by moderate ones, and the least severe reactions. The incidence of adverse reactions is also influenced by risk factors such as female gender, age over 60, SpO2 levels, systolic blood pressure, hypertension, diabetes, cardiovascular disease, asthma, renal impairment, previous allergic and contrast agents reactions. Finally, we also found that we can influence the prevention of nephrotoxicity in various ways. Discussion and conclusion: In Slovenia, there is a lack of research in the field of adverse side effects after the administration of contrast agents, which could be compared with foreign literature and thus come to conclusions about the incidence of side effects in our country. Nevertheless, the objectives of the thesis were achieved, as we found that the diagnostic effect of contrast agents outweighs the occurance of side effects. However, knowing the risk factors can reduce this incidence.

• Ključne besede: diploma theses, radiologic technology, contrast agents, iodine contrast agents, side effects, measures, radilogy