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Acute Amiodarone Pulmonary Toxicity.
Eric T Feduska1, Brandi N Thoma2, Marc C Torjman1
1Department of Anesthesiology, Thomas Jefferson University Hospital, Philadelphia, PA.
Journal of Cardiothoracic and Vascular Anesthesia
|December 2, 2020
Summary
Amiodarone-induced pulmonary toxicity (AIPT) is a serious risk, especially acute respiratory distress syndrome (ARDS) in surgery patients. Conflicting evidence on amiodarone
Area of Science:
- Cardiology
- Pulmonology
- Pharmacology
Background:
- Amiodarone is a vital antiarrhythmic medication used perioperatively.
- Amiodarone-induced pulmonary toxicity (AIPT) is a severe, potentially fatal adverse effect.
- The exact causes and mechanisms of AIPT remain unclear, complicating diagnosis.
Purpose of the Study:
- To review the current understanding of amiodarone-induced pulmonary toxicity (AIPT).
- To clarify the association between amiodarone and acute respiratory distress syndrome (ARDS) in the perioperative setting.
- To highlight the need for further research into acute AIPT.
Main Methods:
- Review of existing cardiothoracic literature on amiodarone and postoperative pulmonary complications.
- Analysis of conflicting evidence regarding amiodarone's role in acute AIPT and ARDS.
- Synthesis of information on the clinical presentation and diagnosis of AIPT.
Main Results:
- Amiodarone-induced pulmonary toxicity (AIPT) presents acutely, subacutely, or chronically, with ARDS being a pattern of acute toxicity.
- Early studies suggested a link between amiodarone and postoperative ARDS.
- More recent research has questioned or found no association between amiodarone and acute AIPT/ARDS.
Conclusions:
- The relationship between amiodarone and acute perioperative pulmonary toxicity, particularly ARDS, requires further investigation.
- Conflicting evidence necessitates clarification due to the drug's frequent use in at-risk populations.
- Amiodarone-induced pulmonary toxicity remains a significant concern requiring ongoing research.
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