Is short-term amiodarone use post cardiac surgery a cause of acute respiratory failure?
OBJECTIVE
It was believed that amiodarone-related adverse respiratory effects were found only when receiving amiodarone on a long-term basis, but several reports seem to contradict this hypothesis. The aim of this study was to evaluate, in an intensive care unit (ICU), the possibility of acute respiratory toxicity induced by short-term amiodarone administration following cardiac surgery.


METHODS
We conducted a prospective clinical trial of 111 consecutive patients admitted to our ICU after cardiac surgery (basically, coronary artery bypass graft and/or valve surgery) and who received short-term prophylactic amiodarone treatment if they were considered at high risk of developing atrial fibrillation. We administered 900 mg/day intravenously for the first 2 days and 600 mg/day on the following days of the ICU stay. The oxygenation index (PaO2/FiO2 ratio) was evaluated at admission, and then 24 and 48 h postsurgery.


RESULTS
One-hundred and two patients were included in the study (9 were excluded for bradycardia), and 25 received amiodarone treatment. The Parsonnet and APACHE II scores differed slightly between the treated and nontreated groups. There were no significant differences between the treated and nontreated groups with respect to left atrial pressure, the number of packed red cells transfused or the oxygenation index at admission and 24 and 48 h postsurgery.


CONCLUSIONS
The short-term administration of amiodarone under the conditions of the present study does not seem to affect respiratory function.
Carrió
M L
ML
Critical Care Service, University Hospital of Bellvitge, C/Feixa Llarga s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain. 27683lcc@comb.es
Fortià
C
C
Javierre
C
C
Rodríguez
D
D
Farrero
E
E
Ricart
A
A
Castells
E
E
Ventura
J L
JL
D000208:Acute Disease; D000368:Aged; D000638:Amiodarone / Q000008:administration & dosage* / Q000009:adverse effects*; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D001281:Atrial Fibrillation / Q000209:etiology / Q000517:prevention & control; D001784:Blood Gas Analysis; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D012131:Respiratory Insufficiency / Q000139:chemically induced*; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents; D000638:Amiodarone