title: Severe Acute Cardiopulmonary Failure Related to Gadobutrol Magnetic Resonance Imaging Contrast Reaction: Successful Resuscitation With Extracorporeal Membrane Oxygenation.
abstract: Nonanaphylactic noncardiogenic pulmonary edema leading to cardiorespiratory arrest related to the magnetic resonance imaging contrast agent gadobutrol has rarely been reported in the literature. Rarer is the association of hypokalemia with acidosis. We report 2 patients who had severe pulmonary edema associated with the use of gadobutrol contrast in the absence of other inciting agents or events. These cases were unique not only for their rare and severe presentations but also because they exemplified the increasing role of extracorporeal membrane oxygenation in resuscitation. Emergency extracorporeal membrane oxygenation resuscitation can be rapidly initiated and successful in the setting of a well-organized workflow, and it is a viable alternative and helps improve patient outcome in cases refractory to conventional resuscitative measures.
authors: Department of Anesthesiology and Critical Care, Mayo Clinic, Rochester, MN.
authors: Pramod K
authors: PK
authors: Guru
authors: Department of Anesthesiology and Critical Care, Mayo Clinic, Rochester, MN.
authors: J Kyle
authors: JK
authors: Bohman
authors: Department of Radiology, Mayo Clinic, Rochester, MN.
authors: Chad J
authors: CJ
authors: Fleming
authors: Department of Anesthesiology and Critical Care, Mayo Clinic, Rochester, MN.
authors: Hon L
authors: HL
authors: Tan
authors: Department of Anesthesiology and Critical Care, Mayo Clinic, Rochester, MN.
authors: Devang K
authors: DK
authors: Sanghavi
authors: Department of Anesthesiology and Critical Care, Mayo Clinic, Rochester, MN.
authors: Alice Gallo
authors: AG
authors: De Moraes
authors: Department of Radiology, Mayo Clinic, Rochester, MN; Division of Cardiovascular Disease, Mayo Clinic, Rochester, MN.
authors: Gregory W
authors: GW
authors: Barsness
authors: Department of Anesthesiology and Critical Care, Mayo Clinic, Rochester, MN.
authors: Erica D
authors: ED
authors: Wittwer
authors: Department of Radiology, Mayo Clinic, Rochester, MN.
authors: Bernard F
authors: BF
authors: King
authors: Department of Anesthesiology and Critical Care, Mayo Clinic, Rochester, MN; Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN.
authors: Grace M
authors: GM
authors: Arteaga
authors: Department of Anesthesiology and Critical Care, Mayo Clinic, Rochester, MN; Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN.
authors: Randall
authors: R
authors: Flick
authors: Department of Anesthesiology and Critical Care, Mayo Clinic, Rochester, MN; Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN. Electronic address: Schears.Gregory@mayo.edu.
authors: Gregory J
authors: GJ
authors: Schears
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000379:methods; D003287:Contrast Media / Q000009:adverse effects*; D004632:Emergency Medical Services / Q000379:methods; D015199:Extracorporeal Membrane Oxygenation; D006323:Heart Arrest / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D009942:Organometallic Compounds / Q000009:adverse effects*; D011654:Pulmonary Edema / Q000209:etiology* / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C090600:gadobutrol