From:
Sukie Crandall
Date: 2005-12-18 18:35:22 UTC
Subject: [ferrethealth] Re: aspirated barium
To: ferrethealth@smartgroups.com
Steve's doctorate is in high energy physics so he is looking to see
if he can run into any medical physics info for you. If he finds
some I will send that along. He wants to know as it just contrast
barium or hot barium? Not all is radioactive; contrast barium is
not, just opaque he THINKS. In what he found there was definite
mention of contrast use and we suspect that you would not normally
want radioactivity in that case. radioactive isotopes take very,
very special care so the chances of a typical vet hospital having
them may be pretty low Steve notes.
With the GI tract things pass our pretty quickly usually (though
there are some structural things that can cause things to hang around
for a while), but in the lungs that is another matter. Now, with
humans we know from Steve's father's past illnesses that it can be
possible to suction debris out of the lungs. I do not know if that
is even possible with ferrets, or even if the equipment would exist
in the right sizes or low enough suction levels.
These might prove useful. Notice that author's contact info is often
present in articles and when it is not it is possible to select the
authors' names for further articles which have such info, or to do a
Google search such as one on the person's talks or for the CV to find
the contact info.
Looking at the related human articles it appears that you and your
vet have done incredible work helping this little one get through
this aspiration accident.
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?
cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16227934&query_hl=1>
> Rev Mal Respir. 2005 Jun;22(3):477-80.
>
>
> [Acute respiratory distress syndrome following inhalation of barium
> sulfate]
>
> [Article in French]
>
> Gernez Y, Barlesi F, Doddoli C, Chetaille B, Forel JM, Astoul P,
> Papazian L.
>
> Service de Reanimation Medicale, Hopital Sainte-Marguerite, Faculte
> de Medecine, Universite de la Mediterranee, Assistance Publique
> Hopitaux de Marseille, Marseille, France.
>
> INTRODUCTION: Barium sulfate (BS) is chosen to explore swallowing
> disorders because of its reduced osmolality allowing no adverse
> reaction if aspirated in the bronchial tree. CASE REPORT: A 66-
> years old man treated for an advanced stage mesothelioma
> experienced a BS aspiration during an esophagography. He developed
> 3 days after an acute respiratory distress syndrome (ARDS) and
> deceased. The post-mortem examination revealed a diffuse alveolar
> damage (DAD). CONCLUSION: Whereas BS aspiration is generally well
> tolerated, serious adverse event as a DAD would exceptionally
> occurs. Thus, a close watch over respiratory symptoms has to be
> kept after BS administration, especially in debilitated and elderly
> patients.
>
> Publication Types:
> Case Reports
>
> PMID: 16227934 [PubMed - in process]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?
cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15827523&query_hl=3
> Rev Mal Respir. 2005 Mar 22; [Epub ahead of print]
>
>
> [Acute respiratory distress syndrome following inhalation of barium
> sulphate.]
>
> [Article in French]
>
> Gernez Y.
>
> Hopitaux de Marseille Service reanimation respira, 270 bd de Sainte
> Marguerite, MARSEILLE, France.
>
> Acute respiratory distress syndrome following inhalation of barium
> sulphate Introduction. Barium sulphate (BS) is used in the
> investigation of disorders of swallowing on account of its low
> osmolality which reduces the risk of pulmonary problems following
> aspiration into the bronchial tree. Case history. We report the
> case of a 66 year old man, treated for pleural mesothelioma,who
> inhaled BS during a barium swallow. Three days later this patient
> developed an acute respiratory distress syndrome from which he
> died. A lung biopsy revealed diffuse alveolar damage (DAD).
> Conclusion. Although inhalation of BS is usually well tolerated,
> severe secondary effects such as DAD may follow. Careful
> observation for respiratory symptoms should therefore be maintained
> following the administration of BS, particularly in elderly or
> debilitated patients. Key words: barium sulphate; barium swallow;
> secondary effect; diffuse alveolar damage; acute respiratory
> distress syndrome. Rev Mal Respir advance online publication, Day
> Month Year; 22 03 2005 doi:10.1019/200530014.
>
> PMID: 15827523 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?
cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=2758750&query_hl=3
> Clin Radiol. 1989 Jul;40(4):397-400.
>
> Aspiration of high-density barium contrast medium causing acute
> pulmonary inflammation--report of two fatal cases in elderly women
> with disordered swallowing.
>
> Gray C, Sivaloganathan S, Simpkins KC.
>
> Department of Pathology, University of Leeds.
>
> Two cases are reported in which accidental inhalation of barium
> contrast medium occurred owing to disordered swallowing in elderly
> women. In each case there was a pulmonary inflammatory reaction
> followed within a few hours by death. Experimental and clinical
> reports of barium inhalation are reviewed and the hazard of
> aspiration of high density barium preparations in elderly and
> debilitated patients with dysphagia is emphasised. It is concluded
> that particular care should be taken in the radiological
> examination of such patients, and a suggested method for performing
> a contrast swallow in those who are liable to aspirate is described.
>
> Publication Types:
> Case Reports
>
> PMID: 2758750 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?
cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=935480&query_hl=3
> Radiology. 1976 Aug;120(2):317.
>
> Fatal aspiration of thick barium.
>
> Lareau DG, Berta JW.
>
> The authors report a case of fatal aspiration of thick barium
> during esophagography in a 75-year-old woman. Apparently the
> patient held much of the barium in her mouth and then aspirated it
> as she tried to swallow. The authors suggest that thick barium be
> avoided when fluoroscopy shows that the patient has difficulty in
> swallowing thin barium and that a suction machine equipped with a
> large-bore catheter be readily available during esophagography,
> particularly in the elderly or obtunded patient.
>
> Publication Types:
> Case Reports
>
> PMID: 935480 [PubMed - indexed for MEDLINE]
-- Sukie (not a vet)
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