Because of their lower incidence of reactions, low-osmolality agents are used by many institutions with selected patients at higher risk for developing a contrast reaction. The American College of Radiology has suggested guidelines for the selective use of low-osmolality agents ( T§b]e,..,2..9.4-6).4 These guidelines are the result of a consensus and are not evidence-based because it is difficult to study severe contrast reactions due to their rarity. Some practices have elected to use low-osmolality agents exclusively, especially since they are generally better tolerated by patients (e.g., less nausea, vomiting, flushing, and heat sensation).
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