The effect of aspirated barium sulfate, iodixanol, and diatrizoic acid on survival and lung injury in a lagomorph model

Siddiqui, Mohamed Tausif; Litts, Juliana K.; Cheney, Diane M.; Kuhn, Maggie A.; Nativ‐Zeltzer, Nogah; Belafsky, Peter C.

doi:10.1002/lary.26494

Cited by 18 publications

(21 citation statements)

References 21 publications

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“…Aspiration of saline, ICA, and NICA did not cause any pathological pulmonary changes and immunological responses in the chronic phase. The high‐osmolality of ICA has been associated with pulmonary congestion in the acute stage, and pulmonary congestion and edema after ICA aspiration are improved within a few days after aspiration . In the chronic stage, it is reported that the reactions to ICA aspiration considerably decreased by the 42nd day, and a similar result was obtained in this study.…”

Section: Discussionsupporting

confidence: 87%

“…The use of swallowing function tests for evaluating patients with dysphagia is prevalent . Contrast videofluoroscopic swallow studies (VFSSs) are an essential part of the diagnostic checkup for persons with a suspected swallowing disorder . Radiographic contrast agents (CAs) are essential in VFSS and upper gastrointestinal studies.…”

Section: Introductionmentioning

confidence: 99%

“…1 Contrast videofluoroscopic swallow studies (VFSSs) are an essential part of the diagnostic checkup for persons with a suspected swallowing disorder. 2 Radiographic contrast agents (CAs) are essential in VFSS and upper gastrointestinal studies. Barium sulfate (Ba), ionic iodinated contrast agent (ICA: diatrizoic acid), and nonionic iodinated contrast agent (NICAs: iohexol, iodixanol) are the most common agents currently used for VFSS and upper gastrointestinal investigations.…”

Section: Introductionmentioning

confidence: 99%

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Chronic inflammatory response in the rat lung to commonly used contrast agents for videofluoroscopy

Ueha

Nativ‐Zeltzer

Sato

et al. 2019

Laryngoscope Investig Oto

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Objectives Contrast agents (CAs) are essential for upper gastrointestinal and videofluoroscopic swallow studies (VFSSs). Recently, we reported that small amounts of Ba aspiration caused severe acute lung inflammation in a rodent model. However, the underlying molecular biological mechanisms of chronic response to CA aspiration remain unclear. The aims of this study were to explore the underlying molecular biological mechanisms of the chronic response to three kinds of CA aspiration on the lung. Study Design Animal model. Methods Eight‐week‐old male Sprague Dawley rats were divided into five groups (n = 6, each group). Three groups underwent tracheal instillation of one of three CAs: barium sulfate (Ba), ionic iodinated contrast agent (ICA), and nonionic iodinated contrast agent (NICA). A sham group was instilled with air and a control group was instilled with saline. All animals were euthanized 30 days after treatment and histological and gene analyses were performed. Results No animal died after CA or sham/control aspiration. Ba particles remained after 30 days and caused histopathologic changes and inflammatory cell infiltration. Iodinated ICA and NICA did not result in perceptible histologic change. Expression of Tnf, an inflammatory cytokine was increased in only Ba aspirated rats ( P = .0076). Other inflammatory cytokines and fibrosis‐related genes did not alter between groups. Conclusion Aspirated Ba particles did not clear from the lung within a month and caused mild chronic pulmonary inflammation. ICA and NICA did not cause any inflammatory responses in the lungs, suggesting that ICA and NICA may be safer CAs for VFSS than Ba. Level of Evidence NA

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Chronic inflammatory response in the rat lung to commonly used contrast agents for videofluoroscopy

Ueha

Nativ‐Zeltzer

Sato

et al. 2019

Laryngoscope Investig Oto

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“…Dynamic contrast videofluoroscopic swallow studies (VFSSs) are an essential part of the diagnostic workup of persons with dysphagia . Radiographic contrast agents (CAs) are also essential in esophagography and more distal upper‐gastrointestinal studies . Barium (Ba) sulfate, nonionic contrast agents (NICAs: iohexol, iodixanol), and ionic contrast agents (ICAs: diatrizoic acid) are the most common CAs currently used for VFSS and upper‐gastrointestinal investigations.…”

Section: Introductionmentioning

confidence: 99%

Acute inflammatory response to contrast agent aspiration and its mechanisms in the rat lung

et al. 2018

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Objectives/Hypothesis Contrast agent (CA) aspiration is an established complication of upper gastrointestinal and videofluoroscopic swallow studies. The underlying molecular biological mechanisms of acute response to CA aspiration in the respiratory organs remain unclear. The aims of this study were to elucidate the histological and biological influences of three kinds of CAs on the lung and to clarify the differences in acute responses. Study Design Animal model. Methods Eight‐week‐old male Sprague Dawley rats were divided into five groups (n = 6 in each group). Three groups underwent tracheal instillation of one of three different CAs: barium (Ba) sulfate, nonionic contrast agents (NICAs), and ionic contrast agents (ICAs). A control group was instilled with saline and a sham group was instilled with air. All animals were euthanized on day 2 after treatment and histological and gene analysis was performed. Results No animal died after CA or control/sham aspiration. Ba caused severe histopathologic changes and more prominent inflammatory cell infiltration in the lungs compared with the two other iodinated contrast agents. Increases in expressions of inflammatory cytokines (tumor necrosis factor [Tnf], interleukin‐1β [Il1b], and interferon‐γ [Ifng]) were observed in Ba aspiration rats, and upregulation of Il1b was seen in ICA aspiration rats. NICA did not cause obvious histologic changes or expressions of inflammatory cytokines and fibrosis‐related genes in the lungs. Conclusions Ba caused significantly more acute lung inflammation in a rodent model than did ioinic and nonionic iodinated CAs. Nonionic contrast did not cause any discernible inflammatory response in the lungs, suggesting that it may be the safest contrast for videofluoroscopic swallow studies. Level of Evidence NA Laryngoscope, 129:1533–1538, 2019

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“…32-37 Second, in cases where contrast evaluation is necessary, some other lung-friendly contrast agents like iopydol, hytrast, and iodixanol can be considered. 12,19,38,39 Last, proper posturing and maneuvers, for example, rotating the head while lying on the side and chin touching the neck during barium swallow, can prevent aspiration of barium sulfate. 40 …”

Section: Discussionmentioning

confidence: 99%

An Esophagogram or Tracheobronchogram? A Review of Barium Sulfate Aspiration

Hamid

Ullah

Rashid

et al. 2018

Journal of Investigative Medicine High Impact Case Reports

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The barium swallow is an important radiological investigation used for the diagnosis of upper gastrointestinal anatomical disorders like esophageal cancer, diverticulum, achalasia, foreign body, among others. Generally, it is believed to be a safe technique with rare complications, but few cases of barium sulfate aspiration have been reported in the literature with multiple complications. We are reporting a case of an elderly male who underwent esophagogram for the workup of chronic dysphagia, aspirated barium sulfate, and went into respiratory failure and circulatory shock several hours later. Moreover, we also did a systematic literature search and reviewed all available articles on aspiration of barium sulfate and its potential complications. We focused on predisposing factors for aspiration, clinical presentation, complications after aspiration, and prognosis with the aim to better understand and manage this condition.

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The effect of aspirated barium sulfate, iodixanol, and diatrizoic acid on survival and lung injury in a lagomorph model

Abstract: NA Laryngoscope, 127:E148-E152, 2017.

Cited by 18 publications

References 21 publications

Chronic inflammatory response in the rat lung to commonly used contrast agents for videofluoroscopy

Chronic inflammatory response in the rat lung to commonly used contrast agents for videofluoroscopy

Acute inflammatory response to contrast agent aspiration and its mechanisms in the rat lung

An Esophagogram or Tracheobronchogram? A Review of Barium Sulfate Aspiration

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