The effect of aspirated barium sulfate, iodixanol, and diatrizoic acid on survival and lung injury in a lagomorph model
Objectives/Hypothesis Contrast agents are an integral component of the video fluoroscopic swallow study. Agents commonly used include barium sulfate (E‐Z Paque), iodixanol (Visipaque), and diatrizoic acid (Gastrografin). Barium is water insoluble, whereas iodixanol and diatrizoic acid are water‐solu...
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| Veröffentlicht in: | The Laryngoscope 2017-05, Vol.127 (5), p.E148-E152 |
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| creator | Siddiqui, M. Tausif Litts, Juliana K. Cheney, Diane M. Kuhn, Maggie A. Nativ‐Zeltzer, Nogah Belafsky, Peter C. |
| description | Objectives/Hypothesis
Contrast agents are an integral component of the video fluoroscopic swallow study. Agents commonly used include barium sulfate (E‐Z Paque), iodixanol (Visipaque), and diatrizoic acid (Gastrografin). Barium is water insoluble, whereas iodixanol and diatrizoic acid are water‐soluble iodine‐based agents. The detrimental effect of these agents on the lungs has not been systematically evaluated. Our aim was to evaluate and compare the effects of aspirated barium, iodixanol, and diatrizoic acid on pulmonary injury in a lagomorph model.
Study Design
Animal model.
Methods
Twenty adult male New Zealand White rabbits were divided into four groups (n = 5). Group 1 received 3 mL of barium sulfate injected into the trachea for 3 consecutive days. Group 2 received 3 mL of iodixanol injected into the trachea for 3 consecutive days. Group 3 received 3 mL of diatrizoic acid injected into the trachea for 3 consecutive days. A control group received 3 mL of air injected into the trachea under an identical protocol. All animals were euthanized on day 4, and the lung and trachea were harvested for blinded histopathologic analysis. The primary outcome measure was survival. The secondary endpoint was a blinded, histologic grading system of lung injury.
Results
Two animals in the barium group, one in the diatrizoic acid group, and 0 animals in the iodixanol and control groups died. The overall lung injury score for the barium (60.60 ± 6.34) and iodixanol groups (52.30 ± 3.11) were significantly higher (worse) than the diatrizoic acid (49.60 ± 7.64) and control groups (37.80 ± 3.56) (P < .05). Diatrizoic acid produced the least amount of lung injury.
Conclusions
The data suggest that 3 mL of aspirated barium sulfate (E‐Z Paque) over 3 consecutive days causes more severe lung injury in a lagomorph model than 3 mL of aspirated iodixanol (Visipaque) and diatrizoic acid (Gastrografin). Diatrizoic acid caused the least histologic evidence of lung injury.
Level of Evidence
NA Laryngoscope, 127:E148–E152, 2017 |
| doi_str_mv | 10.1002/lary.26494 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_2336954419</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2336954419</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4514-c755a7d019d9116911a4fb178848ac7a619a88393995c7d8f2dece60391051be3</originalsourceid><addsrcrecordid>eNp9kcFqGzEURUVpSFwnm35AEXRXMoneSJqRlsE0bcEQCAkkq-FZ0iQympGr8dhxv76KnXaZhXiId7hC5xLyGdgFMFZeBky7i7ISWnwgE5AcCqG1_EgmeckLJcuHE_JpGJaMQc0lOyYnpSo516yckO3ds6OubZ1Z09hSHFY-4dpZusDkx44OY2jz_Zz6aP0L9jGcU-wttR7Xyf-J3lA03tLYZzRt_AbDfh_G_on6fjmmXR4UacCn2MW0eqZdtC6ckqMWw-DO3uaU3F9_v5v9LOY3P37NruaFERJEYWopsbYMtNUAVT4o2gXUSgmFpsYKNCrFNc8fNrVVbWmdcRXjGpiEheNT8vWQu0rx9-iGdbOMY-rzk01WUGkpBOj3KFCqzpYhG5uSbwfKpDgMybXNKvkuy2-ANa9NNK9NNPsmMvzlLXJcdM7-R_-pzwAcgK0PbvdOVDO_un08hP4FHhKS1Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1887100182</pqid></control><display><type>article</type><title>The effect of aspirated barium sulfate, iodixanol, and diatrizoic acid on survival and lung injury in a lagomorph model</title><source>MEDLINE</source><source>Wiley Journals</source><creator>Siddiqui, M. Tausif ; Litts, Juliana K. ; Cheney, Diane M. ; Kuhn, Maggie A. ; Nativ‐Zeltzer, Nogah ; Belafsky, Peter C.</creator><creatorcontrib>Siddiqui, M. Tausif ; Litts, Juliana K. ; Cheney, Diane M. ; Kuhn, Maggie A. ; Nativ‐Zeltzer, Nogah ; Belafsky, Peter C.</creatorcontrib><description>Objectives/Hypothesis
Contrast agents are an integral component of the video fluoroscopic swallow study. Agents commonly used include barium sulfate (E‐Z Paque), iodixanol (Visipaque), and diatrizoic acid (Gastrografin). Barium is water insoluble, whereas iodixanol and diatrizoic acid are water‐soluble iodine‐based agents. The detrimental effect of these agents on the lungs has not been systematically evaluated. Our aim was to evaluate and compare the effects of aspirated barium, iodixanol, and diatrizoic acid on pulmonary injury in a lagomorph model.
Study Design
Animal model.
Methods
Twenty adult male New Zealand White rabbits were divided into four groups (n = 5). Group 1 received 3 mL of barium sulfate injected into the trachea for 3 consecutive days. Group 2 received 3 mL of iodixanol injected into the trachea for 3 consecutive days. Group 3 received 3 mL of diatrizoic acid injected into the trachea for 3 consecutive days. A control group received 3 mL of air injected into the trachea under an identical protocol. All animals were euthanized on day 4, and the lung and trachea were harvested for blinded histopathologic analysis. The primary outcome measure was survival. The secondary endpoint was a blinded, histologic grading system of lung injury.
Results
Two animals in the barium group, one in the diatrizoic acid group, and 0 animals in the iodixanol and control groups died. The overall lung injury score for the barium (60.60 ± 6.34) and iodixanol groups (52.30 ± 3.11) were significantly higher (worse) than the diatrizoic acid (49.60 ± 7.64) and control groups (37.80 ± 3.56) (P < .05). Diatrizoic acid produced the least amount of lung injury.
Conclusions
The data suggest that 3 mL of aspirated barium sulfate (E‐Z Paque) over 3 consecutive days causes more severe lung injury in a lagomorph model than 3 mL of aspirated iodixanol (Visipaque) and diatrizoic acid (Gastrografin). Diatrizoic acid caused the least histologic evidence of lung injury.
Level of Evidence
NA Laryngoscope, 127:E148–E152, 2017</description><identifier>ISSN: 0023-852X</identifier><identifier>EISSN: 1531-4995</identifier><identifier>DOI: 10.1002/lary.26494</identifier><identifier>PMID: 28233902</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Acids ; Animals ; aspiration ; Barium ; barium sulfate ; Barium Sulfate - poisoning ; Contrast agents ; contrast media ; Contrast Media - poisoning ; Diatrizoate - poisoning ; diatrizoic acid ; Disease Models, Animal ; Dysphagia ; E‐Z Paque ; Gastrografin ; iodixanol ; Laboratory animals ; Lung Injury - chemically induced ; Lung Injury - mortality ; Male ; Rabbits ; Respiratory Aspiration ; Throat ; Triiodobenzoic Acids - poisoning ; video fluoroscopic swallow study ; Visipaque</subject><ispartof>The Laryngoscope, 2017-05, Vol.127 (5), p.E148-E152</ispartof><rights>2017 The American Laryngological, Rhinological and Otological Society, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4514-c755a7d019d9116911a4fb178848ac7a619a88393995c7d8f2dece60391051be3</citedby><cites>FETCH-LOGICAL-c4514-c755a7d019d9116911a4fb178848ac7a619a88393995c7d8f2dece60391051be3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Flary.26494$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Flary.26494$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28233902$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Siddiqui, M. Tausif</creatorcontrib><creatorcontrib>Litts, Juliana K.</creatorcontrib><creatorcontrib>Cheney, Diane M.</creatorcontrib><creatorcontrib>Kuhn, Maggie A.</creatorcontrib><creatorcontrib>Nativ‐Zeltzer, Nogah</creatorcontrib><creatorcontrib>Belafsky, Peter C.</creatorcontrib><title>The effect of aspirated barium sulfate, iodixanol, and diatrizoic acid on survival and lung injury in a lagomorph model</title><title>The Laryngoscope</title><addtitle>Laryngoscope</addtitle><description>Objectives/Hypothesis
Contrast agents are an integral component of the video fluoroscopic swallow study. Agents commonly used include barium sulfate (E‐Z Paque), iodixanol (Visipaque), and diatrizoic acid (Gastrografin). Barium is water insoluble, whereas iodixanol and diatrizoic acid are water‐soluble iodine‐based agents. The detrimental effect of these agents on the lungs has not been systematically evaluated. Our aim was to evaluate and compare the effects of aspirated barium, iodixanol, and diatrizoic acid on pulmonary injury in a lagomorph model.
Study Design
Animal model.
Methods
Twenty adult male New Zealand White rabbits were divided into four groups (n = 5). Group 1 received 3 mL of barium sulfate injected into the trachea for 3 consecutive days. Group 2 received 3 mL of iodixanol injected into the trachea for 3 consecutive days. Group 3 received 3 mL of diatrizoic acid injected into the trachea for 3 consecutive days. A control group received 3 mL of air injected into the trachea under an identical protocol. All animals were euthanized on day 4, and the lung and trachea were harvested for blinded histopathologic analysis. The primary outcome measure was survival. The secondary endpoint was a blinded, histologic grading system of lung injury.
Results
Two animals in the barium group, one in the diatrizoic acid group, and 0 animals in the iodixanol and control groups died. The overall lung injury score for the barium (60.60 ± 6.34) and iodixanol groups (52.30 ± 3.11) were significantly higher (worse) than the diatrizoic acid (49.60 ± 7.64) and control groups (37.80 ± 3.56) (P < .05). Diatrizoic acid produced the least amount of lung injury.
Conclusions
The data suggest that 3 mL of aspirated barium sulfate (E‐Z Paque) over 3 consecutive days causes more severe lung injury in a lagomorph model than 3 mL of aspirated iodixanol (Visipaque) and diatrizoic acid (Gastrografin). Diatrizoic acid caused the least histologic evidence of lung injury.
Level of Evidence
NA Laryngoscope, 127:E148–E152, 2017</description><subject>Acids</subject><subject>Animals</subject><subject>aspiration</subject><subject>Barium</subject><subject>barium sulfate</subject><subject>Barium Sulfate - poisoning</subject><subject>Contrast agents</subject><subject>contrast media</subject><subject>Contrast Media - poisoning</subject><subject>Diatrizoate - poisoning</subject><subject>diatrizoic acid</subject><subject>Disease Models, Animal</subject><subject>Dysphagia</subject><subject>E‐Z Paque</subject><subject>Gastrografin</subject><subject>iodixanol</subject><subject>Laboratory animals</subject><subject>Lung Injury - chemically induced</subject><subject>Lung Injury - mortality</subject><subject>Male</subject><subject>Rabbits</subject><subject>Respiratory Aspiration</subject><subject>Throat</subject><subject>Triiodobenzoic Acids - poisoning</subject><subject>video fluoroscopic swallow study</subject><subject>Visipaque</subject><issn>0023-852X</issn><issn>1531-4995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcFqGzEURUVpSFwnm35AEXRXMoneSJqRlsE0bcEQCAkkq-FZ0iQympGr8dhxv76KnXaZhXiId7hC5xLyGdgFMFZeBky7i7ISWnwgE5AcCqG1_EgmeckLJcuHE_JpGJaMQc0lOyYnpSo516yckO3ds6OubZ1Z09hSHFY-4dpZusDkx44OY2jz_Zz6aP0L9jGcU-wttR7Xyf-J3lA03tLYZzRt_AbDfh_G_on6fjmmXR4UacCn2MW0eqZdtC6ckqMWw-DO3uaU3F9_v5v9LOY3P37NruaFERJEYWopsbYMtNUAVT4o2gXUSgmFpsYKNCrFNc8fNrVVbWmdcRXjGpiEheNT8vWQu0rx9-iGdbOMY-rzk01WUGkpBOj3KFCqzpYhG5uSbwfKpDgMybXNKvkuy2-ANa9NNK9NNPsmMvzlLXJcdM7-R_-pzwAcgK0PbvdOVDO_un08hP4FHhKS1Q</recordid><startdate>201705</startdate><enddate>201705</enddate><creator>Siddiqui, M. Tausif</creator><creator>Litts, Juliana K.</creator><creator>Cheney, Diane M.</creator><creator>Kuhn, Maggie A.</creator><creator>Nativ‐Zeltzer, Nogah</creator><creator>Belafsky, Peter C.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope></search><sort><creationdate>201705</creationdate><title>The effect of aspirated barium sulfate, iodixanol, and diatrizoic acid on survival and lung injury in a lagomorph model</title><author>Siddiqui, M. Tausif ; Litts, Juliana K. ; Cheney, Diane M. ; Kuhn, Maggie A. ; Nativ‐Zeltzer, Nogah ; Belafsky, Peter C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4514-c755a7d019d9116911a4fb178848ac7a619a88393995c7d8f2dece60391051be3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Acids</topic><topic>Animals</topic><topic>aspiration</topic><topic>Barium</topic><topic>barium sulfate</topic><topic>Barium Sulfate - poisoning</topic><topic>Contrast agents</topic><topic>contrast media</topic><topic>Contrast Media - poisoning</topic><topic>Diatrizoate - poisoning</topic><topic>diatrizoic acid</topic><topic>Disease Models, Animal</topic><topic>Dysphagia</topic><topic>E‐Z Paque</topic><topic>Gastrografin</topic><topic>iodixanol</topic><topic>Laboratory animals</topic><topic>Lung Injury - chemically induced</topic><topic>Lung Injury - mortality</topic><topic>Male</topic><topic>Rabbits</topic><topic>Respiratory Aspiration</topic><topic>Throat</topic><topic>Triiodobenzoic Acids - poisoning</topic><topic>video fluoroscopic swallow study</topic><topic>Visipaque</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Siddiqui, M. Tausif</creatorcontrib><creatorcontrib>Litts, Juliana K.</creatorcontrib><creatorcontrib>Cheney, Diane M.</creatorcontrib><creatorcontrib>Kuhn, Maggie A.</creatorcontrib><creatorcontrib>Nativ‐Zeltzer, Nogah</creatorcontrib><creatorcontrib>Belafsky, Peter C.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><jtitle>The Laryngoscope</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Siddiqui, M. Tausif</au><au>Litts, Juliana K.</au><au>Cheney, Diane M.</au><au>Kuhn, Maggie A.</au><au>Nativ‐Zeltzer, Nogah</au><au>Belafsky, Peter C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The effect of aspirated barium sulfate, iodixanol, and diatrizoic acid on survival and lung injury in a lagomorph model</atitle><jtitle>The Laryngoscope</jtitle><addtitle>Laryngoscope</addtitle><date>2017-05</date><risdate>2017</risdate><volume>127</volume><issue>5</issue><spage>E148</spage><epage>E152</epage><pages>E148-E152</pages><issn>0023-852X</issn><eissn>1531-4995</eissn><abstract>Objectives/Hypothesis
Contrast agents are an integral component of the video fluoroscopic swallow study. Agents commonly used include barium sulfate (E‐Z Paque), iodixanol (Visipaque), and diatrizoic acid (Gastrografin). Barium is water insoluble, whereas iodixanol and diatrizoic acid are water‐soluble iodine‐based agents. The detrimental effect of these agents on the lungs has not been systematically evaluated. Our aim was to evaluate and compare the effects of aspirated barium, iodixanol, and diatrizoic acid on pulmonary injury in a lagomorph model.
Study Design
Animal model.
Methods
Twenty adult male New Zealand White rabbits were divided into four groups (n = 5). Group 1 received 3 mL of barium sulfate injected into the trachea for 3 consecutive days. Group 2 received 3 mL of iodixanol injected into the trachea for 3 consecutive days. Group 3 received 3 mL of diatrizoic acid injected into the trachea for 3 consecutive days. A control group received 3 mL of air injected into the trachea under an identical protocol. All animals were euthanized on day 4, and the lung and trachea were harvested for blinded histopathologic analysis. The primary outcome measure was survival. The secondary endpoint was a blinded, histologic grading system of lung injury.
Results
Two animals in the barium group, one in the diatrizoic acid group, and 0 animals in the iodixanol and control groups died. The overall lung injury score for the barium (60.60 ± 6.34) and iodixanol groups (52.30 ± 3.11) were significantly higher (worse) than the diatrizoic acid (49.60 ± 7.64) and control groups (37.80 ± 3.56) (P < .05). Diatrizoic acid produced the least amount of lung injury.
Conclusions
The data suggest that 3 mL of aspirated barium sulfate (E‐Z Paque) over 3 consecutive days causes more severe lung injury in a lagomorph model than 3 mL of aspirated iodixanol (Visipaque) and diatrizoic acid (Gastrografin). Diatrizoic acid caused the least histologic evidence of lung injury.
Level of Evidence
NA Laryngoscope, 127:E148–E152, 2017</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>28233902</pmid><doi>10.1002/lary.26494</doi><tpages>5</tpages></addata></record> |
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| ispartof | The Laryngoscope, 2017-05, Vol.127 (5), p.E148-E152 |
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| language | eng |
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| subjects | Acids Animals aspiration Barium barium sulfate Barium Sulfate - poisoning Contrast agents contrast media Contrast Media - poisoning Diatrizoate - poisoning diatrizoic acid Disease Models, Animal Dysphagia E‐Z Paque Gastrografin iodixanol Laboratory animals Lung Injury - chemically induced Lung Injury - mortality Male Rabbits Respiratory Aspiration Throat Triiodobenzoic Acids - poisoning video fluoroscopic swallow study Visipaque |
| title | The effect of aspirated barium sulfate, iodixanol, and diatrizoic acid on survival and lung injury in a lagomorph model |
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