Abstract
Objective: To investigate the safety of using a low osmotic nonionic iodinated contrast agent in the videofluoroscopic examination of swallowing (hereafter “VF”).
Methods: The subjects were patients who underwent VF during admission or outpatient visit to our hospital during the period from April 2015 to March 2017. Exclusion criteria were patients with iodine allergy or serious thyroid disease, and patients who did not give consent to the study. Iopamidol was used as a contrast agent, and was either diluted and mixed into a solid, or diluted as a liquid for oral intake, and the swallowing function was evaluated. For the investigation, the subject cases were investigated retrospectively from the medical records. The side effects described on the package insert of Iopamidol were examined within 7 days after VF and the presence or absence of severe pulmonary impairment complication within 5 days after the examination. In addition, when aspiration was observed, the presence or absence of contrast agent accumulation in the lungs was evaluated by chest X-ray examination.
Results: During the survey period, 452 people (300 men, 152 women, average age 69.4 years) were included. The incidence of side effects was one (0.22%) for each of itching sensation, flushing, and headache, but no serious complication was observed. Fifty-three patients (11.7%) had aspiration during the VF, but no accumulation in the lungs or severe lung injury complication was observed.
Conclusion: By using a low osmotic nonionic iodinated contrast agent, complications rarely occur even when aspiration occurs during the examination, and serious lung damage does not occur, so it is suggested that the test using VF can be conducted safely.
