Low-dose amiodarone-related complications after cardiac operations

Abstract

Preoperative low-dose amiodarone therapy does not seem to be related to significant postoperative lung toxicity, but it is associated with various cardiac complications and an increased need for more intense inotropic support after cardiac operations. These findings may be related to the drug's depressant effect on the myocardium.

Acute Amiodarone-induced Pulmonary Toxicity: An Association of Risk Factors in a Child Operated by Arterial Switch Operation

“…The mechanism involved remains unclear and may be multifactorial: prolonged pump-oxygenator time, anesthetic agents, postoperative pulmonary infection, and exposure to high fraction of inspired oxygen are well-known predisposing factors. 12 Third, the nature of the congenital heart disease may also explain this side effect in our observation. Indeed, patients with transposition of the great arteries are more at risk to have pulmonary arterial hypertension than the general population, but the mechanism still remains unclear in this settings.…”

“…This constitutes, in adults, an important risk factor for developing acute lung injury, including rapidly progressive respiratory distress syndrome, even if the drug is administered at a low dosage. The mechanism involved remains unclear and may be multifactorial: prolonged pump‐oxygenator time, anesthetic agents, postoperative pulmonary infection, and exposure to high fraction of inspired oxygen are well‐known predisposing factors 12 . Third, the nature of the congenital heart disease may also explain this side effect in our observation.…”

Pharmacotherapeutic Considerations in Anesthesia

“…144 -146 Other complications with its use include depressed left ventricular function and respiratory failure. 147,148 More recent reports, however, have failed to document significant complications after cardiac surgery. 149 Amiodarone is being used for the prevention or treatment of postoperative atrial fibrillation.…”

Amiodarone-induced bronchiolitis obliterans organizing pneumonia in patient following percutaneous transluminal coronary angioplasty

“…In most cases, the aetiology remains unknown, although it has been associated with specific diseases and causes including bacterial or viral infections, diseases of the connective tissue, radiation therapy, myelodysplastic syndrome, cocaine abuse, human immunodeficiency virus (HIV) infection, gastrointestinal disorders, coronary artery bypassing grafting, and more various pharmaceutical drugs [3]. Amiodarone is one of the principal drugs involved in pulmonary toxicity, especially in patients undergoing cardiac surgery [4]. The manifestations of pulmonary toxicity from amiodarone, described in the literature include bronchiolitis obliterans with or without signs of organizing pneumonia, with or without chronic interstitial fibrosis, pulmonary solitary or multiple masses or respiratory distress syndrome [5][6][7][8][9][10][11].…”