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Harry W. Fischer, MD
University of Rochester (NY) Medical Center

JAMA. 1989;261(10):1442.

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In Reply.—

In response to Dr Gavant, universal change to low-osmolality agents is not justified to decrease nausea, vomiting, and flushing and warmth sensations and other minor reactions experienced by patients when intravenous contrast media are given, but I agree that the use of low-osmolality agents to lessen patients' intense pain and decrease patient motion during arteriography of the limbs and the external carotid circulation is justified. Also, I agree that the use of low-osmolality contrast media decreases undesired patient movement of extremities and the body and respiratory motion and involuntary coughing during intravenous digital subtraction angiography. In these angiographic examinations, the radiologist should decide if these improvements in radiography techniques justify the added expense.

Concerning Dr Anthony's opinions of whether an open discussion of the use of low-osmolality contrast media produces undesired medicolegal results, I still prefer to have the choices discussed openly in the medical literature. As I . . . [Full Text PDF of this Article]

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