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[Dysphagia] barium and gastrographine
This is the same information I've always been given. Gastrografin is often used in cases where there is a concern for an anastamotic leak (i.e. with a esophagectomy) and not a concern for aspiration. Gastrografin is not necessarily toxic if leaked from the esophagus, but it's extremely harmful if aspirated into the lungs. And from what I've been told by the docs, barium is more harmful if leaked from the esophagus, but does not cause pneumonitis if aspirated. Therefore, barium if concerned about aspiration, gastrografin if concerned about a leak. It's a little concerning that your physician would make such a suggestion knowing how panicked ours get if there's any suspiscion of gastrografin aspiration.
-----Original Message-----
From: LOBSTERPAM@aol.com
To: dgrabo@nycap.rr.com; guapa@otenet.gr
Cc: dysphagia@b9.com
Sent: Wed, 2 Nov 2005 20:58:23 EST
Subject: Re: [Dysphagia] barium and gastrographine
----- Original Message -----
From: Patricia and David <guapa@otenet.gr>
Date: Wednesday, November 2, 2005 5:10 pm
Subject: [Dysphagia] barium and gastrographine
> One of the doctors I work with has mentioned that barium should no
> longer be used in VFSS because of the effects to the lungs it has if
> aspirated, and gastrographine should be used instead. Could anyone
> comment or give me titles of articles I could look up.
>From http://www.emedicine.com/radio/topic57.htm
Gastrografin aspiration: This form of chemical aspiration can rapidly
progress to respiratory failure. Patients may develop immediate cyanosis,
respiratory
distress, and pulmonary edema resulting in cardiopulmonary arrest. Diffuse
bilateral opacities typically are seen on radiographs. One case report exists of
only 50 mL in aspirate volume, quickly leading to acute pulmonary edema and
arrest.
Pam Smith
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