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Journal article
Gadolinium Aspiration Following Inadvertent Endotracheal Tube Cuff Injection in a Pediatric Patient
Journal of medical toxicology, v 15(3), pp 202-204
01 Jul 2019
PMID: 31119526
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
IntroductionGadolinium-based contrast agents (GBCA) are frequently used for MRI contrast studies. We report a case of pulmonary aspiration secondary to inadvertent GBCA injection.Case ReportA 12-year-old female with a past medical history significant for mitochondrial disorder, bronchial asthma, autism, recurrent urinary tract infection, epilepsy, developmental delay, dysautonomia, and thrombocytopenia was scheduled for a contrast-enhanced MRI study using gadoterate meglumine for urinary incontinence. The patient was sedated and intubated in preparation for the study, during which 10 mLof gadoterate meglumine was inadvertently injected into the endotracheal tube cuff pilot line instead of intravenously. The patient remained intubated and was admitted to the intensive care unit with continuous monitoring for signs of pulmonary injury or gadolinium toxicity. She was successfully extubated approximately 24hours later without complication.DiscussionA variety of adverse effects attributable to parenteral GBCA exposure have been reported ranging from mild irritation to life-threatening anaphylaxis. Gadolinium deposition and storage have been implicated in a number of those adverse effects and multiple treatments modalities have been suggested, but no scientifically guided management exists.ConclusionThiscase of pulmonary aspiration secondary to inadvertent GBCA injectionin a pediatric patient demonstratedno acute side effectsor complications within the first 24hours. Withthe wide range of adverse effects attributed to gadolinium usein the medical literature, it is difficult to predict potential future adverse effects.
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Details
- Title
- Gadolinium Aspiration Following Inadvertent Endotracheal Tube Cuff Injection in a Pediatric Patient
- Creators
- Ahmed Mamdouh Taha Mostafa - Drexel Univ, Coll Med, Dept Emergency Med, Div Med Toxicol, 245 N 15th St,Mail Stop 1011, Philadelphia, PA 19102 USAMuhammed Ershad - Drexel UniversityMaricel Dela Cruz - Drexel Univ, Coll Med, Dept Emergency Med, Div Med Toxicol, 245 N 15th St,Mail Stop 1011, Philadelphia, PA 19102 USARita G. McKeever - Drexel UniversityDavid Vearrier - Drexel UniversityMichael I. Greenberg - Drexel University
- Publication Details
- Journal of medical toxicology, v 15(3), pp 202-204
- Publisher
- Springer Nature
- Number of pages
- 3
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Microbiology and Immunology; College of Medicine; Emergency Medicine
- Web of Science ID
- WOS:000473147800009
- Scopus ID
- 2-s2.0-85066902731
- Other Identifier
- 991019169812704721
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- Web of Science research areas
- Toxicology