[Management of severe amiodarone-induced pneumopathy using inhaled nitric oxide]

Treatment of amiodarone-induced pulmonary toxicity generally consists in simply discontinuing the drug with subsequent improvement in clinical condition and radiologic abnormalities. Corticosteroid therapy, when used, may accelerate recovery. Early diagnosis is however necessary and mandates the immediate cessation of the drug otherwise diffuse interstitial and alveolar damage can develop and lead to acute respiratory distress syndrome with a high rate mortality. To our knowledge, the use of inhaled nitric oxide to improve arterial oxygenation in amiodarone-induced ARDS has not yet been described. Here we report the case of a patient in whom 2 ppm inhaled nitric oxide in association with mechanical ventilation dramatically improved a life-threatening hypoxemia. We therefore submit that inhaled nitric oxide could be of benefit in patients with amiodarone-induced ARDS.