Lumason and Cardiopulmonary reactions

Serious, potentially fatal cardiopulmonary reactions have infrequently occurred during or following the injection of ultrasound contrast agents including sulfur hexafluoride and perfluten. Most serious reactions have been observed within 30 minutes of administration. Patients with unstable cardiopulmonary conditions such as acute myocardial infarction, acute coronary artery syndromes, worsening or unstable congestive heart failure, or serious ventricular arrhythmias may be at increased risk for developing these reactions. Patients receiving these agents should be monitored for acute reactions including cardiac or respiratory arrest, shock, syncope, symptomatic arrhythmias (e.g., atrial fibrillation, tachycardia, bradycardia, supraventricular tachycardia, ventricular fibrillation, ventricular tachycardia), hypertension, hypotension, dyspnea, hypoxia, chest pain, respiratory distress, stridor, wheezing, loss of consciousness, and convulsions. Cardiopulmonary resuscitation personnel and equipment should be readily available at all times.

These agents should be used with caution in patients with known or suspected right-to-left, bidirectional, or transient right-to-left cardiac shunts. In such patients, concerns exist that some of the intravenously injected lipid- containing microspheres may bypass filtering by the lung and directly enter the arterial circulation. Occlusion of the microcirculation by these microspheres may result in tissue ischemia. Patients should be closely monitored after administration and assessed for any embolism phenomena.