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Hu C, Feng Y, Huang P, Jin J. Adverse reactions after the use of SonoVue contrast agent: Characteristics and nursing care experience. Medicine (Baltimore) 2019; 98:e17745. [PMID: 31689827 PMCID: PMC6946512 DOI: 10.1097/md.0000000000017745] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The aim of this study was to analyze the clinical manifestations of adverse reactions after the use of SonoVue contrast agent from a large retrospective database, and to evaluate the nursing care strategies and the efficacy of standardized procedure for adverse reactions of SonoVue (SPARS).From January 1, 2012 to December 30, 2018, 34,478 cases of contrast-enhanced ultrasonography were performed in our center. The clinical manifestations of adverse reactions after the use of SonoVue contrast agent were identified and analyzed. The nursing care strategies were evaluated and the outcomes of patients with moderate and severe adverse reactions before and after the application of SPARS were compared.Of the 34,478 cases, 40 cases (0.12%) of adverse reactions after the use of SonoVue were identified. Adverse reactions included anaphylatic shock, skin allergies, nausea or vomiting, dizziness or headache, numbness, chest distress, back pain, and local reactions of the injection site. Most of the adverse reactions were mild and self-limited. Only 3 cases of anaphylatic shock and 2 cases of severe rash underwent further treatments. The 3 patients who were managed by SPARS recovered quicker and spent less comparing with the other 2 patients who were not.SonoVue was a safe contrast agent, with few and mostly mild adverse reactions. SPARS may be an efficient way in tackling moderate to severe adverse reactions, although of which the incidence was rare.
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Affiliation(s)
- Chenlu Hu
- Department of Interventional Ultrasound
| | | | | | - Jingfen Jin
- Department of Nursing, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Tang C, Fang K, Guo Y, Li R, Fan X, Chen P, Chen Z, Liu Q, Zou Y. Safety of Sulfur Hexafluoride Microbubbles in Sonography of Abdominal and Superficial Organs: Retrospective Analysis of 30,222 Cases. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2017; 36:531-538. [PMID: 28072475 DOI: 10.7863/ultra.15.11075] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 06/03/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES The purpose of this study was to investigate the safety of the sulfur hexafluoride microbubble contrast agent SonoVue (Bracco SpA, Milan, Italy) and to implement precautions with the intent of further improving the safety of this contrast agent. METHODS A total of 30,222 patients undergoing contrast-enhanced sonography of abdominal and superficial organs in our hospital from January 2005 to December 2014 were retrospectively investigated. SonoVue was used as the ultrasound contrast agent. The symptoms and treatments of adverse reactions occurring during the contrast-enhanced sonographic examinations were reviewed and analyzed. RESULTS No patient died as a result of any adverse reaction. Six patients (0.020%) had adverse reactions of varying degrees, including 2 patients (0.007%) who had signs of early anaphylactic shock (chest tightness, palpitations, sweating, and rapid and weak pulse, followed by cyanosis, a disappearing pulse, and a drop in blood pressure) that improved after active rescue. The remaining 4 patients developed the following: redness and a rash on the arm above the injection site, nasal bleeding and nausea, nausea and vomiting, and back pain with numbness of the lips and limbs. Symptoms in these 4 patients self-resolved after a period of rest. CONCLUSIONS Contrast-enhanced sonography with sulfur hexafluoride microbubbles had good clinical safety, but rare adverse reactions were observed. A comprehensive emergency plan and rescue measures for adverse reactions should be prepared and made available to minimize the occurrence of negative clinical outcomes.
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Affiliation(s)
- Chunlin Tang
- Department of Ultrasound, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Kejing Fang
- Department of Ultrasound, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Yanli Guo
- Department of Ultrasound, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Rui Li
- Department of Ultrasound, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Xiaozhou Fan
- Department of Ultrasound, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Ping Chen
- Department of Ultrasound, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Zhaohui Chen
- Department of Ultrasound, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Qiangwei Liu
- Department of Ultrasound, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Ye Zou
- Department of Ultrasound, Southwest Hospital, Third Military Medical University, Chongqing, China
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Prütz M, Hungerbühler S, Laß M, Fehr M, Günther P, Mathes K. Contrast echocardiography for analysis of heart anatomy in tortoises. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2015; 43:231-7. [PMID: 26105200 DOI: 10.15654/tpk-140152] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 01/29/2015] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The cardiac anatomy in tortoises depicted on B-mode and color-Doppler should be better differentiated by additional contrast-echocardiography. MATERIAL AND METHODS An intravenous contrast agent (INN-sulphur hexafluoride [SonoVue®]) was injected in four tortoises (three Testudo hermanni, one Agrionemys horsfieldii), via the coccygeal vein, with parallel B-mode echocardiographic examination. The results of the contrast-enhanced echocardiography were compared with the contrast-free B-mode recordings and color-Doppler ultrasound. RESULTS The use of SonoVue® enabled clearer distinction of the cardiac structures, differentiation of the arising major arteries, identification of wash-out-shunts, and visualization of blood flow patterns throughout the tortoise heart. CONCLUSION AND CLINICAL RELEVANCE This study enables the accurate depiction and differentiation of cardiac anatomy in tortoises through the use of a combination of B-mode, color-Doppler and contrast-echocardiography. Basic knowledge of blood flow in the reptile heart is essential to understand echocardiographic anatomy. Blood-flow-patterns and anatomy of the tortoise heart as found in this study will help to establish a basis for further echocardiographic examinations of these animals.
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Affiliation(s)
- M Prütz
- Dr. Maike Prütz, Clinic for Pets, Reptiles, Pet and Feral Birds, University of Veterinary Medicine Hannover, Bünteweg 9, 30559 Hannover, Germany, E-Mail:
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Perera RH, Hernandez C, Zhou H, Kota P, Burke A, Exner AA. Ultrasound imaging beyond the vasculature with new generation contrast agents. WILEY INTERDISCIPLINARY REVIEWS-NANOMEDICINE AND NANOBIOTECHNOLOGY 2015; 7:593-608. [PMID: 25580914 DOI: 10.1002/wnan.1326] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 10/17/2014] [Accepted: 11/08/2014] [Indexed: 12/21/2022]
Abstract
Current commercially available ultrasound contrast agents are gas-filled, lipid- or protein-stabilized microbubbles larger than 1 µm in diameter. Because the signal generated by these agents is highly dependent on their size, small yet highly echogenic particles have been historically difficult to produce. This has limited the molecular imaging applications of ultrasound to the blood pool. In the area of cancer imaging, microbubble applications have been constrained to imaging molecular signatures of tumor vasculature and drug delivery enabled by ultrasound-modulated bubble destruction. Recently, with the rise of sophisticated advancements in nanomedicine, ultrasound contrast agents, which are an order of magnitude smaller (100-500 nm) than their currently utilized counterparts, have been undergoing rapid development. These agents are poised to greatly expand the capabilities of ultrasound in the field of targeted cancer detection and therapy by taking advantage of the enhanced permeability and retention phenomenon of many tumors and can extravasate beyond the leaky tumor vasculature. Agent extravasation facilitates highly sensitive detection of cell surface or microenvironment biomarkers, which could advance early cancer detection. Likewise, when combined with appropriate therapeutic agents and ultrasound-mediated deployment on demand, directly at the tumor site, these nanoparticles have been shown to contribute to improved therapeutic outcomes. Ultrasound's safety profile, broad accessibility and relatively low cost make it an ideal modality for the changing face of healthcare today. Aided by the multifaceted nano-sized contrast agents and targeted theranostic moieties described herein, ultrasound can considerably broaden its reach in future applications focused on the diagnosis and staging of cancer.
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Affiliation(s)
- Reshani H Perera
- Department of Radiology, Case Western Reserve University, Cleveland, OH, USA
| | - Christopher Hernandez
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Haoyan Zhou
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Pavan Kota
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Alan Burke
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Agata A Exner
- Department of Radiology, Case Western Reserve University, Cleveland, OH, USA
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Yuan L, Xie M, Cheng TO, Wang X, Zhu F, Kong X, Ghoorah D. Left ventricular noncompaction associated with hypertrophic cardiomyopathy: Echocardiographic diagnosis and genetic analysis of a new pedigree in China. Int J Cardiol 2014; 174:249-59. [DOI: 10.1016/j.ijcard.2014.03.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 03/07/2014] [Indexed: 01/10/2023]
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Streitberger A, Hocke V, Modler P. Measurement of pulmonary transit time in healthy cats by use of ultrasound contrast media "Sonovue®": feasibility, reproducibility, and values in 42 cats. J Vet Cardiol 2013; 15:181-7. [PMID: 23933477 DOI: 10.1016/j.jvc.2013.05.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Revised: 05/01/2013] [Accepted: 05/06/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the feasibility of measuring pulmonary transit time (PTT) in healthy cats by transthoracic echocardiography using the ultrasound contrast agent Sonovue(®). To determine normalized PTT (nPTT) values in 42 healthy cats and to estimate the interobserver variability and the within-day repeatability of nPTT measurements. ANIMALS Forty-two privately owned healthy cats of different breeds, gender and age presented for cardiac examination. METHODS A bolus injection of contrast agent (Sonovue(®)) was administered intravenously. The right parasternal short axis echocardiographic view was used to record the contrast agent's transit time from the pulmonary artery to the left atrium. Pulmonary transit time and nPTT were determined independently by three examiners with different levels of experience. RESULTS Normalized PTT was 4.12 ± 1.0 (mean ± SD) in our population. The median interobserver variability across our population was 6.8%, the median within-day variability for the three observers were 13.1%, 12.7% and 13%. No effect of the observer's experience on nPTT measurement was identified. Age, sex and body weight did not significantly influence nPTT. CONCLUSIONS This study demonstrates that nPTT measurement is feasible in cats using ultrasound and the blood pool contrast media Sonovue(®). Measurements of nPTT can be performed in a clinical setting. Normalized PTT values in healthy cats are comparable with those reported in healthy dogs.
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Galema TW, Geleijnse ML, Vletter WB, de Laat L, Michels M, Ten Cate FJ. Clinical usefulness of SonoVue contrast echocardiography: the Thoraxcentre experience. Neth Heart J 2012; 15:55-60. [PMID: 17612661 PMCID: PMC1847751 DOI: 10.1007/bf03085955] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Although other imaging techniques, such as magnetic resonance imaging and computer tomography, are becoming more and more important in cardiology, two-dimensional echocardiography is still the most used technique in clinical cardiology. Quantification of left ventricular function and dimensions is important because therapeutic strategies, for example implanting an ICD after myocardial infarction, are based on ejection fraction measurements. Because of the sometimes low quality of echocardiographic images we started to use an ultrasound contrast agent and in this article we describe our experiences with SonoVue, a second-generation contrast agent, over a threeyear period in the Thoraxcentre. (Neth Heart J 2007;15:55-60.).
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Affiliation(s)
- T W Galema
- Thoraxcentre, Erasmus Medical Centre, Rotterdam, the Netherlands
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Crosara S, Ljungvall I, Margiocco ML, Häggström J, Tarducci A, Borgarelli M. Use of contrast echocardiography for quantitative and qualitative evaluation of myocardial perfusion and pulmonary transit time in healthy dogs. Am J Vet Res 2012; 73:194-201. [PMID: 22280378 DOI: 10.2460/ajvr.73.2.194] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate reproducibility of ejection fraction (EF), myocardial perfusion (MP), and pulmonary transit time (PTT) measured in a group of dogs by use of contrast echocardiography and to examine safety of this method by evaluating cardiac troponin I concentrations. ANIMALS 6 healthy dogs. PROCEDURES 2 bolus injections and a constant rate infusion of contrast agent were administered IV. Echocardiographic EF was determined by use of the area-length method and was calculated without and with contrast agent. The PTT and normalized PTT (PTT/mean R-R interval) were measured for each bolus. Constant rate infusion was used for global MP evaluation, and regional MP was calculated by use of a real-time method in 4 regions of interest of the left ventricle. Cardiac troponin I concentration was analyzed before and after contrast agent administration. Intraoberserver and interobserver variability was calculated. RESULTS EF was easier to determine with the ultrasonographic contrast agent. For the first and second bolus, mean ± SD PTT was 1.8 ± 0.2 seconds and 2.1 ± 0.3 seconds and normalized PTT was 3.4 ± 0.3 seconds and 3.5 ± 0.3 seconds, respectively. A coefficient of variation < 15% was obtained for global MP but not for the regional MPs. No differences were detected between precontrast and postcontrast cardiac troponin I concentrations. CONCLUSIONS AND CLINICAL RELEVANCE Contrast echocardiography appeared to be a repeat-able and safe technique for use in the evaluation of global MP and PTT in healthy dogs, and it improved delineation of the endocardial border in dogs.
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Affiliation(s)
- Serena Crosara
- Department of Animal Pathology, University of Torino, Grugliasco, Italy.
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Ionescu A. Bubble trouble: anaphylactic shock, threatened myocardial infarction, and transient renal failure after intravenous echo contrast for left ventricular cavity opacification preceding dobutamine stress echo. ACTA ACUST UNITED AC 2009; 10:707-10. [DOI: 10.1093/ejechocard/jep073] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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