INTRAVENOUS USE OF IONIC AND NONIONIC CONTRAST AGENTS IN CHILDREN

PURPOSE: To determine the use of intravenous ionic and nonionic contrast agents in children. MATERIALS AND METHODS: The director of pediatric radiology at 59 of 65 large children's hospitals in North America responded to a questionnaire. RESULTS: Thirty-nine institutions used only nonionic contrast agents, one used only ionic, and 19 used both. Among those who used both, various criteria were used for selection of nonionic contrast agents. These criteria were rigidly enforced in only five of 18 institutions. The most common indication for the use of nonionic contrast agents was a severe reaction to any contrast agent, allergy, or poor renal function. Because nonionic contrast agents are more expensive, 18 of 58 directors of pediatric radiology were under pressure from hospital administrators to decrease use of these agents. The use of nonionic agents was justified because patients experienced fewer minor reactions to the agent. CONCLUSION: Most pediatric institutions use nonionic contrast agents, but many still use ionic agents for intravenous administration for selected indications.