The effect of some contrast agents in the lung: an experimental study in the rat and dog

Wh, McAlister; Askin, FB

doi:10.2214/ajr.140.2.245

Cited by 50 publications

(34 citation statements)

References 3 publications

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“…In animals LOWS contrast media produced less lung damage than hypertonic water soluble contrast media or barium suspensions [12,20]. The introduction of barium [19] and hypertonic [13] contrast media into the peritoneum produces inflammatory changes.…”

Section: Discussionmentioning

confidence: 98%

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The use of low osmolality water soluble (LOWS) contrast media in the pediatric gastro-intestinal tract

Ratcliffe¹

1986

Pediatr Radiol

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There are dangers in the use of either barium sulphate suspensions or the conventional hypertonic water soluble contrast media in the gastrointestinal tract of "at risk" babies and children. These dangers can be avoided by the use of low osmolality water soluble (LOWS) contrast media. This paper reports the satisfactory use of three such contrast media, ioxaglate (Hexabrix), iohexol (Omnipaque) and iopamidol (Niopam) in 115 examinations of the gastrointestinal tracts of 89 babies and children. Morbidity from the inhalation or extravasation of contrast medium was negligible. It is proposed that LOWS contrast media should be used more widely in the gastro-intestinal investigation of all "at risk" babies and children.

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Section: Discussionmentioning

confidence: 98%

“…Barium is contraindicated if free peritoneal, mediastinal or pleural leak is susPected [6,7,18,19]. Hypertonic contrast media exacerbate dehydration [10,11] and cause inflammation and pain [12].…”

Section: Discussionmentioning

confidence: 99%

The use of low osmolality water soluble (LOWS) contrast media in the pediatric gastro-intestinal tract

Ratcliffe¹

1986

Pediatr Radiol

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“…Studies have therefore been performed in rats [17-19, 22, 30, 31], guinea pigs [23], rabbits [20,21] and dogs [18] to assess the damage of aspiration of commonly used watersoluble contrast media. As a result, it has been established that although some of these contrast media are not suitable to use for intrabronchial diagnostic procedures, other nonionic media did not cause harm to the respiratory system [17][18][19][20][21][22][23][24]31]. Similarly, LARSEN et al [25] reported that nonionic iso-osmolar contrast media, including iodixanol, when instilled intratracheally did not induce lung tissue damage or lead to respiratory complications.…”

Section: Discussionmentioning

confidence: 99%

“…There are contradictory reports on the seriousness of adverse effects when commonly used contrast media are aspirated in the lungs [17][18][19][20][21][22]. However, it has been shown that nonionic and isotonic agents are well tolerated and cause fewer pulmonary complications than ionic and hyperosmolar agents [17-19, 23, 24].…”

mentioning

confidence: 99%

Iodixanol inhibits exogenous surfactant therapy in rats with acute respiratory distress syndrome

Kesecioğlu¹,

Schultz²,

Haitsma³

et al. 2002

Eur Respir J

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Optimal alveolar distribution of exogenous surfactant is an important determinant of its beneficial effect. This distribution can be determined by suspending surfactant in a radiological contrast medium before intratracheal instillation, followed by radiological imaging. Iodixanol is reported to be a safe contrast medium that causes no lung injury when instilled intratracheally.In this study, the effects of surfactant suspended in saline were compared with surfactant suspended either in 4:1 saline-iodixanol (64 mg iodine?mL -1 ) or in 1:1 salineiodixanol (160 mg iodine?mL -1 ), on oxygenation and lung mechanics in a rat model of adult respiratory distress syndrome (ARDS) induced by lung lavage.After the induction of ARDS, surfactant instillation improved oxygenation, total lung volume at inflation with a distending pressure of 35 cmH 2 O, lung volume at transpulmonary pressure of 5 cmH 2 O and Gruenwald index. The effects of surfactant suspended in 4:1 saline-iodixanol were similar to those of surfactant alone. However, instillation of surfactant suspended in 1:1 saline-iodixanol resulted in significantly lower values in all measured parameters. Surface tension was the lowest in surfactant suspended in saline alone and addition of iodixanol led to an increase in surface tension in a dose-dependent manner.In conclusion, iodixanol at the higher dose caused an inhibition of the exogenous surfactant effect, characterized as a lack of improvement in oxygen tension in arterial blood, low total lung compliance, volume at 5 cmH 2 O end-expiration and Gruenwald index. This effect of iodixanol was probably due to its high surface tension, especially if a high concentration was used. Surfactant suspended in a lower concentration of iodixanol seems a better alternative, allowing for radiological imaging of the distribution of surfactant when intratracheally instilled.

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“…Because of the inert character of barium sulfate no lung injury characterized by polymorphonuclear neutrophil leukocytes sequestration and edema usually seen after acid aspiration occurs [4,5]. However, there are reports of acute inflammation of the bronchial wall after barium aspiration which have been attributed to high density preparations (250% w/v) of barium sulfate [6,7], but have also been reported using lower density barium sulfate preparations [8]. Moreover, hypersensitivity reactions caused by one of the many additives to commercial barium preparations have been observed [6].…”

Section: Discussionmentioning

confidence: 99%

Severe Barium Sulfate Aspirationinto the Lung: Clinical Presentation, Prognosis and Therapy

Tamm

Kortsik

1999

Respiration

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Aspiration of large amounts of barium sulfate is a rare incident during radiographic contrast procedures. Here we describe two patients, who developed acute dyspnea after aspiration of significant amounts of barium into the lung during an upper gastrointestinal radiographic contrast study. The regions of the lung involved depended on the position of the patients during and after aspiration. Arterial blood gas analysis revealed hypoxemia due to alveolar shunt with V/Q distribution disturbances. Bronchoscopy was performed to extract the contrast medium from the tracheobronchial tree. The patients could be discharged a few days later with normal lung function. Long-term prognosis is generally excellent due to the inert character of barium sulfate, even though impressive radiographic findings remain.

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The effect of some contrast agents in the lung: an experimental study in the rat and dog

Cited by 50 publications

References 3 publications

The use of low osmolality water soluble (LOWS) contrast media in the pediatric gastro-intestinal tract

The use of low osmolality water soluble (LOWS) contrast media in the pediatric gastro-intestinal tract

Iodixanol inhibits exogenous surfactant therapy in rats with acute respiratory distress syndrome

Severe Barium Sulfate Aspirationinto the Lung: Clinical Presentation, Prognosis and Therapy

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