The safety of intravenous fluorescein for confocal laser endomicroscopy in the gastrointestinal tract

M. B. Wallace, A. Meining, M. I. Canto, P. Fockens, S. Miehlke, T. Roesch, C. J. Lightdale, H. Pohl, D. Carr-Locke, M. LÖhr, E. Coron, B. Filoche, M. Giovannini, J. Moreau, C. Schmidt, R. Kiesslich

Research output: Contribution to journalArticle

193 Citations (Scopus)

Abstract

Aliment Pharmacol Ther 31, 548-552 SummaryBackground Confocal laser endomicroscopy (CLE) is rapidly emerging as a valuable tool for gastrointestinal endoscopic imaging. Fluorescent contrast agents are used to optimize imaging with CLE, and intravenous fluorescein is the most widely used contrast agent. Fluorescein is FDA-cleared for diagnostic angiography of the retina. For these indications, the safety profile of fluorescein has been well-documented; however, to date, fluorescein is not cleared for use with CLE. Aims To estimate the rate of serious and total adverse events attributable to intravenous fluorescein when used for gastrointestinal CLE. Methods We performed a cross sectional survey of 16 International Academic Medical Centres with active research protocols in CLE that involved intravenous fluorescein. Centres using i.v. fluorescein for CLE who were actively monitored for adverse events were included. Results Sixteen centres performed 2272 gastrointestinal CLE procedures. The most common dose of contrast agent was 2.5-5 mL of 10% sodium fluorescein. No serious adverse events were reported. Mild adverse events occurred in 1.4% of individuals, including nausea/vomiting, transient hypotension without shock, injection site erythema, diffuse rash and mild epigastric pain. The limitation is that only immediate post procedure events were actively monitored. Conclusions Use of intravenous fluorescein for gastrointestinal CLE appears to be safe with few acute complications.

Original languageEnglish (US)
Pages (from-to)548-552
Number of pages5
JournalAlimentary Pharmacology and Therapeutics
Volume31
Issue number5
DOIs
StatePublished - Mar 2010

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Fluorescein
Gastrointestinal Tract
Lasers
Safety
Contrast Media
Erythema
Exanthema
Fluorescent Dyes
Hypotension
Nausea
Vomiting
Retina
Shock
Angiography
Cross-Sectional Studies
Pain
Injections
Research

ASJC Scopus subject areas

  • Pharmacology (medical)

Cite this

Wallace, M. B., Meining, A., Canto, M. I., Fockens, P., Miehlke, S., Roesch, T., ... Kiesslich, R. (2010). The safety of intravenous fluorescein for confocal laser endomicroscopy in the gastrointestinal tract. Alimentary Pharmacology and Therapeutics, 31(5), 548-552. https://doi.org/10.1111/j.1365-2036.2009.04207.x

The safety of intravenous fluorescein for confocal laser endomicroscopy in the gastrointestinal tract. / Wallace, M. B.; Meining, A.; Canto, M. I.; Fockens, P.; Miehlke, S.; Roesch, T.; Lightdale, C. J.; Pohl, H.; Carr-Locke, D.; LÖhr, M.; Coron, E.; Filoche, B.; Giovannini, M.; Moreau, J.; Schmidt, C.; Kiesslich, R.

In: Alimentary Pharmacology and Therapeutics, Vol. 31, No. 5, 03.2010, p. 548-552.

Research output: Contribution to journalArticle

Wallace, MB, Meining, A, Canto, MI, Fockens, P, Miehlke, S, Roesch, T, Lightdale, CJ, Pohl, H, Carr-Locke, D, LÖhr, M, Coron, E, Filoche, B, Giovannini, M, Moreau, J, Schmidt, C & Kiesslich, R 2010, 'The safety of intravenous fluorescein for confocal laser endomicroscopy in the gastrointestinal tract', Alimentary Pharmacology and Therapeutics, vol. 31, no. 5, pp. 548-552. https://doi.org/10.1111/j.1365-2036.2009.04207.x
Wallace, M. B. ; Meining, A. ; Canto, M. I. ; Fockens, P. ; Miehlke, S. ; Roesch, T. ; Lightdale, C. J. ; Pohl, H. ; Carr-Locke, D. ; LÖhr, M. ; Coron, E. ; Filoche, B. ; Giovannini, M. ; Moreau, J. ; Schmidt, C. ; Kiesslich, R. / The safety of intravenous fluorescein for confocal laser endomicroscopy in the gastrointestinal tract. In: Alimentary Pharmacology and Therapeutics. 2010 ; Vol. 31, No. 5. pp. 548-552.
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abstract = "Aliment Pharmacol Ther 31, 548-552 SummaryBackground Confocal laser endomicroscopy (CLE) is rapidly emerging as a valuable tool for gastrointestinal endoscopic imaging. Fluorescent contrast agents are used to optimize imaging with CLE, and intravenous fluorescein is the most widely used contrast agent. Fluorescein is FDA-cleared for diagnostic angiography of the retina. For these indications, the safety profile of fluorescein has been well-documented; however, to date, fluorescein is not cleared for use with CLE. Aims To estimate the rate of serious and total adverse events attributable to intravenous fluorescein when used for gastrointestinal CLE. Methods We performed a cross sectional survey of 16 International Academic Medical Centres with active research protocols in CLE that involved intravenous fluorescein. Centres using i.v. fluorescein for CLE who were actively monitored for adverse events were included. Results Sixteen centres performed 2272 gastrointestinal CLE procedures. The most common dose of contrast agent was 2.5-5 mL of 10{\%} sodium fluorescein. No serious adverse events were reported. Mild adverse events occurred in 1.4{\%} of individuals, including nausea/vomiting, transient hypotension without shock, injection site erythema, diffuse rash and mild epigastric pain. The limitation is that only immediate post procedure events were actively monitored. Conclusions Use of intravenous fluorescein for gastrointestinal CLE appears to be safe with few acute complications.",
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AU - Miehlke, S.

AU - Roesch, T.

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AU - Coron, E.

AU - Filoche, B.

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AU - Moreau, J.

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