Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034063 (pulmonary edema)
 10,665 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 43-year-old man with dysphagia and a tendency to aspirate was found to have squamous cell carcinoma of the esophagus. Curative surgery was planned and preoperative computed tomography of the chest and abdomen was ordered. A ward nurse administered Gastrografin according to a "standing" order, 4 hours before the CT was to be done. The patient aspirated about 50 mL of Gastrografin, and went into cardiorespiratory arrest caused by pulmonary edema. He sustained severe brain damage and died. This is a first report of lethal aspiration of Gastrografin, given in preparation for CT. We advise alerting nurses who administer Gastrografin, especially to patients with dysphagia or impaired consciousness about the grave consequences that can result if the contrast agent is aspirated by the patient. We further advise that responsibility for using contrast agents in radiologic procedures be assumed by the radiologist and not by medical house staff.
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PMID:Gastrografin-induced aspiration pneumonia: a lethal complication of computed tomography. 147 Sep 76

Despite the widespread use and the assumed safety of Omnipaque (iohexol) and 3% Gastrografin (meglumine diatrizoate) as contrast media for esophagography and computed tomography respectively, their effects on the lung if they are aspirated have never been studied. This information is important because such compounds may inadvertently enter the lungs during the diagnostic procedures. Twenty-four rats were injected intratracheally with 0.15 mL of one of three contrast agents (omnipaque, full-strength Gastrografin and 3% Gastrografin) or normal saline, which was used as a control. Radiographs were then obtained. Equal numbers from each experimental group were sacrificed after 5 minutes, 1 hour and 24 hours, and their lungs were examined pathologically. The rats injected with full-strength Gastrografin all died immediately of gross pulmonary edema. Neither Omnipaque nor 3% Gastrografin was fatal, but Omnipaque produced more edema and alveolar hemorrhage than either normal saline or 3% Gastrografin. Iohexol is, therefore, more irritating to the airways and the lung parenchyma than previously believed.
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PMID:Direct effects of contrast media on rat lungs. 188 57

Twenty-six patients with possible esophageal disruption who were also at risk for aspiration or direct communication of the esophagus with the tracheobronchial tree were examined with iohexol esophagography. Fifteen patients had normal studies confirmed by findings at a barium examination performed immediately after. In 11 patients abnormalities were diagnosed on the basis of iohexol esophagograms; the abnormalities included extraluminal extravasation of contrast material (n = 7), aspiration (n = 1), esophageal stricture with intramural diverticulosis (n = 1), edema of the gastroesophageal junction (n = 1), and epiphrenic diverticulum (n = 1). Eight of these patients were immediately reexamined with barium esophagography, which yielded no additional information. Low-osmolality, water-soluble contrast agents are a safe alternative for patients in whom barium esophagography poses a risk of mediastinitis and esophagography with diatrizoate meglumine and diatrizoate sodium (Gastrografin) poses a risk of pulmonary edema.
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PMID:Esophageal disruption: evaluation with iohexol esophagography. 278 Oct 24

The effects of saline and 3 contrast media, Amipaque, Gastrografin and barium, were evaluated for 24 hours following intratracheal instillation in rabbits. Respiratory rates, serial chest films, and pathologic examination of the lungs demonstrated that Amipaque induced significantly less respiratory distress than the other 2 contrast media whereas inflammatory reactions were comparable for all of the media. Significant pulmonary edema occurred with both Amipaque and Gastrografin but was greater with Gastrografin. Both of these media were cleared from the lung within 24 hours, however barium continued to obstruct bronchi and fill alveolar air spaces. It is concluded that in comparison to Gastrografin and barium, Amipaque is relatively innocuous in the lung.
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PMID:Clinical, radiographic and pathologic effects of Amipaque on rabbit lung. Comparison with barium and Gastrografin. 717 Oct 23