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Titolo:
Experimental study of mortality and morbidity of contrast media and standardized fecal dose in the peritoneal cavity
Autore:
Hernanz-Schulman, M; Foster, C; Maxa, R; Battles, G; Dutt, P; Stratton, C; Holburn, G; Schulman, G; Neblett, WW; Shyr, Y; Hakim, RR; Vanholder, R; Heller, RM;
Indirizzi:
Vanderbilt Univ, Med Ctr, Dept Pediat Radiol & Radiol Sci, Nashville, TN 37232 USA Vanderbilt Univ Nashville TN USA 37232 adiol Sci, Nashville, TN 37232 USA Vanderbilt Univ, Med Ctr, Dept Pathol, Nashville, TN 37232 USA Vanderbilt Univ Nashville TN USA 37232 pt Pathol, Nashville, TN 37232 USA Vanderbilt Univ, Med Ctr, Dept Microbiol, Nashville, TN 37232 USA Vanderbilt Univ Nashville TN USA 37232 Microbiol, Nashville, TN 37232 USA Vanderbilt Univ, Med Ctr, Dept Pediat Surg, Nashville, TN 37232 USA Vanderbilt Univ Nashville TN USA 37232 diat Surg, Nashville, TN 37232 USA Vanderbilt Univ, Med Ctr, Dept Med, Nashville, TN 37232 USA Vanderbilt Univ Nashville TN USA 37232 Dept Med, Nashville, TN 37232 USA Vanderbilt Univ, Med Ctr, Dept Biostat, Nashville, TN 37232 USA VanderbiltUniv Nashville TN USA 37232 t Biostat, Nashville, TN 37232 USA State Univ Ghent, Dept Med, Ghent, Belgium State Univ Ghent Ghent Belgium ate Univ Ghent, Dept Med, Ghent, Belgium
Titolo Testata:
PEDIATRIC RADIOLOGY
fascicolo: 6, volume: 30, anno: 2000,
pagine: 369 - 378
SICI:
0301-0449(200006)30:6<369:ESOMAM>2.0.ZU;2-W
Fonte:
ISI
Lingua:
ENG
Soggetto:
GUIDED HYDROSTATIC REDUCTION; EXPERIMENTAL INTRAABDOMINAL ABSCESSES; CHILDHOOD INTUSSUSCEPTION; BARIUM PERITONITIS; AIR; MANAGEMENT; CHILDREN; PERFORATION; DIAGNOSIS; AGENTS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
34
Recensione:
Indirizzi per estratti:
Indirizzo: Hernanz-Schulman, M Vanderbilt Univ, Med Ctr, Dept Pediat Radiol & Radiol Sci, D-1120 MCN, Nashville, TN 37232 USA Vanderbilt Univ D-1120 MCN Nashville TN USA 37232 USA
Citazione:
M. Hernanz-Schulman et al., "Experimental study of mortality and morbidity of contrast media and standardized fecal dose in the peritoneal cavity", PEDIAT RAD, 30(6), 2000, pp. 369-378

Abstract

Background. The use of radiographic contrast media in the setting of possible bowel ischemia and potential perforation is known to be associated withincreased clinical risk. However there is a lack of controlled studies using a standard native: fecal load to define and compare the intrinsic mortality and morbidity among options of contrast media currently available to the radiologist. We have compared the mortality and gross and histopathologicmorbidity of a standard intraperitoneal native fecal dose in the guinea pig, using barium, two iodinated media, saline and air. Materials and methods. The study was performed on adult Hartley guinea pigs. A standard native fecal solution with a colony count of 10(8) aerobes and 2 x 10(7) anaerobes was prepared, and the LD50 of intraperitoneal injection of the solution was determined. The standard solution at the LD50 dose was then used to compare the mortality and morbidity when commercial barium sulfate (18% w/v), Conray 30 (iothalamate meglumine 30%), 1:1 dilution of Conray 30 with sterile water, termed Conray "15" (iothalamate meglumine 15%), saline and air, were added to the intraperitoneal injection of the fecal solution in five groups of 20 animals each. Mortality and acute (96 h) and chronic (30 days) gross and histopathology were assessed and graded according to a standard system and analyzed statistically. Results. Barium was significantly more deleterious than the dilute water-soluble iodinated media, saline and air. Mortality occurred within 24 h in the barium group and within the initial 48 h in all groups as follows: barium 19/20 (95%); Conray 30 16/20 (80%); Conray "15" 7/20 (35%); saline 0; air0. Acute gross and histopathology showed extensive grade 4 lesions in 19/19 barium animals; less severe lesions were present in a lesser percentage of the animals in the other four groups. Entirely chronic lesions were present only in the single surviving barium animal and were nonsignificant (<400mu m) or absent in the other four groups. Conclusions. In our study, barium incurred the most significant deleterious short and long-term effects in the setting of fecal peritonitis. Dilute water-soluble media offer a much greater margin of safety. Saline under sonographic guidance is less deleterious than any of the positive radiographic contrast media. However, in our study, air was the safest contrast medium in the setting of peritoneal soiling.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/01/20 alle ore 18:31:49