{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T17:20:19Z","timestamp":1781457619568,"version":"3.54.1"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2024,9,1]],"date-time":"2024-09-01T00:00:00Z","timestamp":1725148800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Endosc Ultrasound"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:sec>\n            <jats:title>Background and Objectives<\/jats:title>\n            <jats:p>Sulfur hexafluoride is an inert gas that creates microbubbles to enhance diagnostic accuracy in a variety of ultrasound (US) studies and is widely used in EUS. We analyzed the reported adverse events (AEs) of the US contrast agent, sulfur hexafluoride, extensively used during EUS procedures using a US national database.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>From December 2008 to January 2024, AEs reported in the Federal Drug Administration Adverse Event Reporting System database for sulfur hexafluoride were examined.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>There were 1069 individual reports analyzed. Reports were excluded if they contained drugs other than sulfur hexafluoride. Echocardiogram (70.9%) was the common diagnostic study in which sulfur hexafluoride was administered. The most common AE reported was anaphylactic reaction (<jats:italic toggle=\"yes\">n<\/jats:italic> = 179, 16.7%), followed by hypotension (<jats:italic toggle=\"yes\">n<\/jats:italic> = 162, 15.2%), cardiac arrest (<jats:italic toggle=\"yes\">n<\/jats:italic> = 161, 15.1%), and dyspnea (<jats:italic toggle=\"yes\">n<\/jats:italic> = 159, 14.9%). The most common gastrointestinal AE was nausea (<jats:italic toggle=\"yes\">n<\/jats:italic> = 135, 12.6%). Severity of AEs ranged from nonserious to death. Death associated with sulfur hexafluoride use was reported in 58 patients (5.4% of AE reports).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Anaphylactic reaction was the most common AE reported with sulfur hexafluoride use, and severe AEs including death may be more common than prior large, retrospective, observational studies to date have suggested.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/eus.0000000000000086","type":"journal-article","created":{"date-parts":[[2024,11,10]],"date-time":"2024-11-10T23:00:08Z","timestamp":1731279608000},"page":"306-311","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Safety of the contrast enhancement agent sulfur hexafluoride in ultrasound: Analysis of the Federal Drug Administration Adverse Event Reporting System database"],"prefix":"10.1097","volume":"13","author":[{"given":"Courtney N.","family":"Walker","sequence":"first","affiliation":[{"name":"Center for Advanced Therapeutic Endoscopy (CATE), Porter Adventist Hospital\/PEAK Gastroenterology, Denver, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael B.","family":"Andrews","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas G.","family":"Adler","sequence":"additional","affiliation":[{"name":"Center for Advanced Therapeutic Endoscopy (CATE), Porter Adventist Hospital\/PEAK Gastroenterology, Denver, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,11,8]]},"reference":[{"issue":"6","key":"bib1-20250826","first-page":"384","article-title":"Anaphylactic shock with an ultrasound contrast agent","volume":"42","year":"2017","journal-title":"J Med Vasc"},{"issue":"3","key":"bib2-20250826","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1016\/j.gie.2011.03.1246","article-title":"Techniques of image enhancement in EUS (with videos)","volume":"74","year":"2011","journal-title":"Gastrointest Endosc"},{"issue":"4","key":"bib3-20250826","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1016\/j.gie.2016.06.006","article-title":"The clinical impact of ultrasound contrast agents in EUS: a systematic review according to the levels of evidence","volume":"84","year":"2016","journal-title":"Gastrointest Endosc"},{"issue":"3","key":"bib5-20250826","doi-asserted-by":"crossref","first-page":"161","DOI":"10.14366\/usg.14017","article-title":"Contrast-enhanced endoscopic ultrasonography: advance and current status","volume":"33","year":"2014","journal-title":"Ultrasonography"},{"issue":"2","key":"bib6-20250826","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1111\/echo.14963","article-title":"Innovative method to diagnose coronary cameral fistula by contrast echocardiography","volume":"38","year":"2021","journal-title":"Echocardiography"},{"key":"bib7-20250826","first-page":"231782","article-title":"The role of contrast-enhanced ultrasound in selection indication and improveing diagnosis for transthoracic biopsy in peripheral pulmonary and mediastinal lesions","volume":"2015","year":"2015","journal-title":"Biomed Res Int"},{"key":"bib8-20250826","doi-asserted-by":"crossref","first-page":"e294","DOI":"10.5114\/pjr.2023.128866","article-title":"Lung ultrasound in a nutshell. Lines, signs, some applications, and misconceptions from a radiologist's point of view","volume":"88","year":"2023","journal-title":"Pol J Radiol"},{"issue":"Suppl 2","key":"bib9-20250826","first-page":"S1","article-title":"Current indications for contrast echocardiography imaging","volume":"6","year":"2005","journal-title":"Eur J Echocardiogr"},{"issue":"2","key":"bib10-20250826","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1016\/j.ultrasmedbio.2022.09.014","article-title":"Safety analysis of adverse events of ultrasound contrast agent Lumason\/SonoVue in 49,100 patients","volume":"49","year":"2023","journal-title":"Ultrasound Med Biol"},{"issue":"6","key":"bib11-20250826","first-page":"1170","article-title":"Safety of SF6(SonoVue\u00ae) contrast agent on pharmacological stress echocardiogram","volume":"117","year":"2021","journal-title":"Arq Bras Cardiol"},{"key":"bib12-20250826","doi-asserted-by":"crossref","first-page":"1225654","DOI":"10.3389\/fcvm.2023.1225654","article-title":"Safety of Lumason\u00ae (SonoVue\u00ae) in special populations and critically ill patients","volume":"10","year":"2023","journal-title":"Front Cardiovasc Med"},{"issue":"1","key":"bib13-20250826","first-page":"11","article-title":"Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS) in the liver\u2014update 2012: a WFUMB-EFSUMB initiative in cooperation with representatives of AFSUMB, AIUM, ASUM, FLAUS and ICUS","volume":"34","year":"2013","journal-title":"Ultraschall Med"},{"issue":"3","key":"bib14-20250826","doi-asserted-by":"crossref","first-page":"531","DOI":"10.7863\/ultra.15.11075","article-title":"Safety of sulfur hexafluoride microbubbles in sonography of abdominal and superficial organs: retrospective analysis of 30,222 cases","volume":"36","year":"2017","journal-title":"J Ultrasound Med"},{"issue":"6","key":"bib16-20250826","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1097\/RMR.0000000000000107","article-title":"How to manage (treat) immediate-type adverse reactions to GBCA","volume":"25","year":"2016","journal-title":"Top Magn Reson Imaging"}],"container-title":["Endoscopic Ultrasound"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/eus.0000000000000086","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T18:00:27Z","timestamp":1756231227000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/eus.0000000000000086"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9]]},"references-count":14,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.1097\/eus.0000000000000086","relation":{},"ISSN":["2226-7190","2303-9027"],"issn-type":[{"value":"2226-7190","type":"electronic"},{"value":"2303-9027","type":"print"}],"subject":[],"published":{"date-parts":[[2024,9]]}}}