The use of low-osmolar water-soluble contrast in videofluoroscopic swallowing exams

Julie A. Harris, Detlef Bartelt, Molly Campion, Bob W. Gayler, Bronwyn Jones, Andrea Hayes, Judith Haynos, Seanne Herbick, Therese Kling, Arpana Lingaraj, Michele Singer, Heather Starmer, Christine Smith, Kimberly T Webster

Research output: Contribution to journalArticle

Abstract

The selection of the contrast agent used during fluoroscopic exams is an important clinical decision. The purpose of this article is to document the usage of a nonionic, water-soluble contrast (iohexol) and barium contrast in adult patients undergoing fluoroscopic exams of the pharynx and/or esophagus and provide clinical indications for the use of each. For 1 year, data were collected on the use of iohexol and barium during fluoroscopic exams. The contrast agent used was selected by the speech language pathologist (SLP) or the radiologist based on the exam's indications. A total of 1,978 fluoroscopic exams were completed in the 12-month period of documentation. Of these exams, 60.6 % were completed for medical reasons and 39.4 % for surgical reasons. Fifty-five percent of the exams were performed jointly by a SLP and a radiologist and 45 % were performed by a radiologist alone. Aspiration was present in 22 % of the exams, vestibular penetration occurred in 38 %, extraluminal leakage of contrast was observed in 4.6 %, and both aspiration and leakage were seen in 1 % of the exams. In cases with aspiration, iohexol was used alone in 8 %, iohexol and barium were both used in 45 %, and barium was used alone in 47 %. In cases with extraluminal leakage, iohexol was used alone in 58 %, iohexol and barium were both used in 31 %, and barium was used alone in 11 %. No adverse effects were seen with the use of iohexol. When barium was used in cases of aspiration and extraluminal leakage, the amount of aspirated barium was small and the extraluminal barium in the instances of leakage was small. Iohexol is a useful screening contrast agent and can safely provide information, and its use reduces the risk of aspiration and the chance of leakage of large amounts of barium.

Original languageEnglish (US)
Pages (from-to)520-527
Number of pages8
JournalDysphagia
Volume28
Issue number4
DOIs
StatePublished - Dec 2013

Fingerprint

Iohexol
Barium
Deglutition
Water
Contrast Media
Language
Pharynx
Documentation
Esophagus
Aspirations (Psychology)

Keywords

  • Deglutition
  • Deglutition disorders
  • Fluoroscopic exams
  • Iodine-containing contrast
  • Iohexol
  • Omnipaque

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Gastroenterology
  • Speech and Hearing

Cite this

Harris, J. A., Bartelt, D., Campion, M., Gayler, B. W., Jones, B., Hayes, A., ... Webster, K. T. (2013). The use of low-osmolar water-soluble contrast in videofluoroscopic swallowing exams. Dysphagia, 28(4), 520-527. https://doi.org/10.1007/s00455-013-9462-0

The use of low-osmolar water-soluble contrast in videofluoroscopic swallowing exams. / Harris, Julie A.; Bartelt, Detlef; Campion, Molly; Gayler, Bob W.; Jones, Bronwyn; Hayes, Andrea; Haynos, Judith; Herbick, Seanne; Kling, Therese; Lingaraj, Arpana; Singer, Michele; Starmer, Heather; Smith, Christine; Webster, Kimberly T.

In: Dysphagia, Vol. 28, No. 4, 12.2013, p. 520-527.

Research output: Contribution to journalArticle

Harris, JA, Bartelt, D, Campion, M, Gayler, BW, Jones, B, Hayes, A, Haynos, J, Herbick, S, Kling, T, Lingaraj, A, Singer, M, Starmer, H, Smith, C & Webster, KT 2013, 'The use of low-osmolar water-soluble contrast in videofluoroscopic swallowing exams', Dysphagia, vol. 28, no. 4, pp. 520-527. https://doi.org/10.1007/s00455-013-9462-0
Harris JA, Bartelt D, Campion M, Gayler BW, Jones B, Hayes A et al. The use of low-osmolar water-soluble contrast in videofluoroscopic swallowing exams. Dysphagia. 2013 Dec;28(4):520-527. https://doi.org/10.1007/s00455-013-9462-0
Harris, Julie A. ; Bartelt, Detlef ; Campion, Molly ; Gayler, Bob W. ; Jones, Bronwyn ; Hayes, Andrea ; Haynos, Judith ; Herbick, Seanne ; Kling, Therese ; Lingaraj, Arpana ; Singer, Michele ; Starmer, Heather ; Smith, Christine ; Webster, Kimberly T. / The use of low-osmolar water-soluble contrast in videofluoroscopic swallowing exams. In: Dysphagia. 2013 ; Vol. 28, No. 4. pp. 520-527.
@article{91468eb4cc8d48799c459ff7d6d8f685,
title = "The use of low-osmolar water-soluble contrast in videofluoroscopic swallowing exams",
abstract = "The selection of the contrast agent used during fluoroscopic exams is an important clinical decision. The purpose of this article is to document the usage of a nonionic, water-soluble contrast (iohexol) and barium contrast in adult patients undergoing fluoroscopic exams of the pharynx and/or esophagus and provide clinical indications for the use of each. For 1 year, data were collected on the use of iohexol and barium during fluoroscopic exams. The contrast agent used was selected by the speech language pathologist (SLP) or the radiologist based on the exam's indications. A total of 1,978 fluoroscopic exams were completed in the 12-month period of documentation. Of these exams, 60.6 {\%} were completed for medical reasons and 39.4 {\%} for surgical reasons. Fifty-five percent of the exams were performed jointly by a SLP and a radiologist and 45 {\%} were performed by a radiologist alone. Aspiration was present in 22 {\%} of the exams, vestibular penetration occurred in 38 {\%}, extraluminal leakage of contrast was observed in 4.6 {\%}, and both aspiration and leakage were seen in 1 {\%} of the exams. In cases with aspiration, iohexol was used alone in 8 {\%}, iohexol and barium were both used in 45 {\%}, and barium was used alone in 47 {\%}. In cases with extraluminal leakage, iohexol was used alone in 58 {\%}, iohexol and barium were both used in 31 {\%}, and barium was used alone in 11 {\%}. No adverse effects were seen with the use of iohexol. When barium was used in cases of aspiration and extraluminal leakage, the amount of aspirated barium was small and the extraluminal barium in the instances of leakage was small. Iohexol is a useful screening contrast agent and can safely provide information, and its use reduces the risk of aspiration and the chance of leakage of large amounts of barium.",
keywords = "Deglutition, Deglutition disorders, Fluoroscopic exams, Iodine-containing contrast, Iohexol, Omnipaque",
author = "Harris, {Julie A.} and Detlef Bartelt and Molly Campion and Gayler, {Bob W.} and Bronwyn Jones and Andrea Hayes and Judith Haynos and Seanne Herbick and Therese Kling and Arpana Lingaraj and Michele Singer and Heather Starmer and Christine Smith and Webster, {Kimberly T}",
year = "2013",
month = "12",
doi = "10.1007/s00455-013-9462-0",
language = "English (US)",
volume = "28",
pages = "520--527",
journal = "Dysphagia",
issn = "0179-051X",
publisher = "Springer New York",
number = "4",

}

TY - JOUR

T1 - The use of low-osmolar water-soluble contrast in videofluoroscopic swallowing exams

AU - Harris, Julie A.

AU - Bartelt, Detlef

AU - Campion, Molly

AU - Gayler, Bob W.

AU - Jones, Bronwyn

AU - Hayes, Andrea

AU - Haynos, Judith

AU - Herbick, Seanne

AU - Kling, Therese

AU - Lingaraj, Arpana

AU - Singer, Michele

AU - Starmer, Heather

AU - Smith, Christine

AU - Webster, Kimberly T

PY - 2013/12

Y1 - 2013/12

N2 - The selection of the contrast agent used during fluoroscopic exams is an important clinical decision. The purpose of this article is to document the usage of a nonionic, water-soluble contrast (iohexol) and barium contrast in adult patients undergoing fluoroscopic exams of the pharynx and/or esophagus and provide clinical indications for the use of each. For 1 year, data were collected on the use of iohexol and barium during fluoroscopic exams. The contrast agent used was selected by the speech language pathologist (SLP) or the radiologist based on the exam's indications. A total of 1,978 fluoroscopic exams were completed in the 12-month period of documentation. Of these exams, 60.6 % were completed for medical reasons and 39.4 % for surgical reasons. Fifty-five percent of the exams were performed jointly by a SLP and a radiologist and 45 % were performed by a radiologist alone. Aspiration was present in 22 % of the exams, vestibular penetration occurred in 38 %, extraluminal leakage of contrast was observed in 4.6 %, and both aspiration and leakage were seen in 1 % of the exams. In cases with aspiration, iohexol was used alone in 8 %, iohexol and barium were both used in 45 %, and barium was used alone in 47 %. In cases with extraluminal leakage, iohexol was used alone in 58 %, iohexol and barium were both used in 31 %, and barium was used alone in 11 %. No adverse effects were seen with the use of iohexol. When barium was used in cases of aspiration and extraluminal leakage, the amount of aspirated barium was small and the extraluminal barium in the instances of leakage was small. Iohexol is a useful screening contrast agent and can safely provide information, and its use reduces the risk of aspiration and the chance of leakage of large amounts of barium.

AB - The selection of the contrast agent used during fluoroscopic exams is an important clinical decision. The purpose of this article is to document the usage of a nonionic, water-soluble contrast (iohexol) and barium contrast in adult patients undergoing fluoroscopic exams of the pharynx and/or esophagus and provide clinical indications for the use of each. For 1 year, data were collected on the use of iohexol and barium during fluoroscopic exams. The contrast agent used was selected by the speech language pathologist (SLP) or the radiologist based on the exam's indications. A total of 1,978 fluoroscopic exams were completed in the 12-month period of documentation. Of these exams, 60.6 % were completed for medical reasons and 39.4 % for surgical reasons. Fifty-five percent of the exams were performed jointly by a SLP and a radiologist and 45 % were performed by a radiologist alone. Aspiration was present in 22 % of the exams, vestibular penetration occurred in 38 %, extraluminal leakage of contrast was observed in 4.6 %, and both aspiration and leakage were seen in 1 % of the exams. In cases with aspiration, iohexol was used alone in 8 %, iohexol and barium were both used in 45 %, and barium was used alone in 47 %. In cases with extraluminal leakage, iohexol was used alone in 58 %, iohexol and barium were both used in 31 %, and barium was used alone in 11 %. No adverse effects were seen with the use of iohexol. When barium was used in cases of aspiration and extraluminal leakage, the amount of aspirated barium was small and the extraluminal barium in the instances of leakage was small. Iohexol is a useful screening contrast agent and can safely provide information, and its use reduces the risk of aspiration and the chance of leakage of large amounts of barium.

KW - Deglutition

KW - Deglutition disorders

KW - Fluoroscopic exams

KW - Iodine-containing contrast

KW - Iohexol

KW - Omnipaque

UR - http://www.scopus.com/inward/record.url?scp=84890974346&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84890974346&partnerID=8YFLogxK

U2 - 10.1007/s00455-013-9462-0

DO - 10.1007/s00455-013-9462-0

M3 - Article

VL - 28

SP - 520

EP - 527

JO - Dysphagia

JF - Dysphagia

SN - 0179-051X

IS - 4

ER -