Fatal postoperative amiodarone pulmonary toxicity

Amiodarone-induced Acute Respiratory Distress Syndrome Masquerading as Acute Heart Failure

“…It has been reported in patients who underwent surgery or pulmonary angiography and were receiving amiodarone either before or after the procedure (6)(7)(8)(9). In surgical case series, the development of ARDS with amiodarone therapy occurred within 1-4 days after extubation (6)(7)(8). In a report of 2 cases, rapid respiratory deterioration ensued within 30 min after pulmonary angiography (9).…”

“…Clinical resolution takes place within 2-4 weeks, although radiological findings persist for 3 months (18). The mortality from amiodarone-induced ARDS has been reported as high as 30-50% (5,7,8).…”

Postoperative Amiodarone Pulmonary Toxicity

“…Life-threatening respiratory failure due to APT may also occur following non-cardiac surgery. 2 The mechanism of acute postoperative APT is uncertain. It is likely that subclinical toxicity exists preoperatively and is exacerbated by perioperative fctors such as oxygen toxicity or congestive cardiac failure.…”

Relationship between amiodarone-induced subclinical lung toxicity and Th1/Th2 balance

“…This serious complication is steroid-sensitive in early phase and observed progressively or rapidly under continued maintenance therapy. Reportedly, it is also triggered by superimposed infection or surgery [11,12], implying inflammatory mediated mechanisms of amiodarone lung toxicity. These findings indicate that this toxicity is not always dependent on the cumulative dose of oral amiodarone, but rather attributed to different individual amiodarone susceptibility regulated probably by pharmacogenomics.…”