2004
DOI: 10.1111/j.1365-2044.2004.03614.x
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Angiotensin‐converting enzyme inhibitor related angioedema and the anaesthetist

Abstract: SummaryAngioedema of the face and neck is an uncommon but potentially life-threatening complication of angiotensin-converting enzyme (ACE) inhibitor therapy. This condition is of particular concern to the anaesthetist as it can rapidly progress to upper airway obstruction. We describe the presentation and management of five cases of ACE inhibitor related angioedema, all of which were associated with significant upper airway obstruction.

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Cited by 27 publications
(26 citation statements)
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“…Postoperative swelling of the tongue due to idiosyncratic angioneurotic edema from ACE inhibitor therapy has been reported to occur following airway manipulation. [1][2][3][4][5][6][7][8] Over an 18-month period we have encountered four cases of ACEI-induced angioedema in which delayed swelling of the supraglottic tissues led to the requirement for airway support despite simultaneous resolution of tongue swelling. Had we not been aware of this possibility, airway compromise may have occurred.…”
Section: Introductionmentioning
confidence: 99%
“…Postoperative swelling of the tongue due to idiosyncratic angioneurotic edema from ACE inhibitor therapy has been reported to occur following airway manipulation. [1][2][3][4][5][6][7][8] Over an 18-month period we have encountered four cases of ACEI-induced angioedema in which delayed swelling of the supraglottic tissues led to the requirement for airway support despite simultaneous resolution of tongue swelling. Had we not been aware of this possibility, airway compromise may have occurred.…”
Section: Introductionmentioning
confidence: 99%
“…However, the problem of ACEIinduced angioedema remains under-recognized [1][2][3][4][5][6] despite the fact that the association between ACEI and angioedema is well documented in the literature, and it is now considered to be one of the commonest causes of non-hereditary angioedema. 7,8 The problem of ACEI-induced angioedema is particularly relevant to anesthesiologists and emergency medicine physicians, as angioedema can cause rapid and progressive airway compromise which may be life-threatening. A significant number of patients now present to the emergency department with this complication.…”
Section: Discussionmentioning
confidence: 99%
“…66 Up to 20% of patients may present with acute onset of dyspnea, dysphagia, dysphonia and stridor, with rapid progression to life-threatening airway obstruction. 1,7,89,90 Attempts have been made to correlate either the symptoms at presentation or the anatomic site of edema, with subsequent management and outcome. Ishoo et al reviewed 93 episodes of angioedema over a ten-year period, and proposed a staging system by which airway risk could be predicted from the site of presentation.…”
Section: Clinical Presentation Of Acei Angioedemamentioning
confidence: 99%
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“…To the Editor: In their review of the anaesthetic implications of angiotensin converting enzyme inhibitors (ACEI) and angioedema, 1 2 Four patients had a tracheostomy, and three of these were performed following awake fibreoptic intubation.…”
Section: Airway Management In Angiotensin Converting Enzyme Inhibitormentioning
confidence: 99%