Acute amiodarone-induced lung toxicity.
OBJECTIVE
To investigate any relationship between the pathological features of amiodarone-induced pulmonary toxicity (APT) and clinical use of amiodarone in patients dying from acute respiratory distress syndrome (ARDS).


METHODS
Retrospective study. Review of clinical and pathological findings of patients dying from ARDS.


METHODS
Intensive Care Unit (ICU) and Pathology Department of University hospital.


METHODS
Ten patients with clinical diagnosis of ARDS, who died in ICU and underwent post mortem examination.


METHODS
Case note review of clinical details; independent review of histological specimens.


RESULTS
Over a 3-year period, ten patients underwent post mortem examination, of whom seven had received amiodarone. Three patients who received longer than 48 h of amiodarone had histological changes of widespread lipoid pneumonia, a recognised pattern of APT.


CONCLUSIONS
Acute amiodarone pulmonary toxicity is a definite pathological entity in ICU patients. High oxygen concentrations may be a risk factor, while pre-existing pathology, e. g. ARDS, may mask its development. Amiodarone should be used with caution in this group of patients.
Department of Anaesthetics, Ninewells Hospital, Dundee, UK.
L
L
Donaldson
I S
IS
Grant
M R
MR
Naysmith
J S
JS
Thomas
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000638:Amiodarone / Q000009:adverse effects*; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects*; D002423:Cause of Death; D016208:Databases, Factual; D006801:Humans; D008875:Middle Aged; D010102:Oxygen Inhalation Therapy; D011017:Pneumonia, Lipid / Q000139:chemically induced* / Q000401:mortality / Q000473:pathology; D012128:Respiratory Distress Syndrome / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D012189:Retrospective Studies; D016037:Single-Blind Method; D013617:Tachycardia, Supraventricular / Q000188:drug therapy; D017211:Treatment Failure
D000889:Anti-Arrhythmia Agents; D000638:Amiodarone