Acute pulmonary oedema following administration of vasopressin for control of massive GI tract haemorrhage in a major burn patient.
A 35-year-old male sustained a full-skin thickness chemical burn involving 60 per cent of TBSA when hydrochloric acid was applied to his face, trunk and extremities by his girlfriend. Debridements and skin graftings were performed smoothly and he was doing well until day 23 after injury, when massive GI tract bleeding caused a drop in blood pressure. Vasopressin was given intravenously to control the bleeding, which stopped, and the blood pressure returned to normal after transfusion. After the vasopressin infusion was tapered off acute pulmonary oedema developed abruptly, which required treatment by intubation and PEEP using a respirator. The lung condition had returned to normal by the following day. A second episode of massive GI tract bleeding recurred 10 days later, again vasopressin was given through a catheter into the inferior mesenteric artery. Again pulmonary oedema developed 38 h after the vasopressin use, the oedema disappeared within 2 days when the vasopressin infusion tapered off. It should be kept in mind that acute pulmonary oedema may develop when high doses of vasopressin are used in the treatment of Curling's ulcer or other GI tract bleeding.
Lin
T W
TW
Burn Institute of National Taiwan University Hospital, RO China.
Kuo
Y S
YS
D000208:Acute Disease; D000328:Adult; D002057:Burns, Chemical / Q000150:complications* / Q000628:therapy; D003646:Debridement; D006471:Gastrointestinal Hemorrhage / Q000150:complications / Q000188:drug therapy*; D006490:Hemostatics / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D011654:Pulmonary Edema / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D013902:Radiography, Thoracic; D012867:Skin / Q000293:injuries; D016038:Skin Transplantation; D014667:Vasopressins / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use
D006490:Hemostatics; D014667:Vasopressins