Fadahunsi Opeyemi, Krol Ronald
Department of Medicine, Reading Health System, West Reading, PA, USA;
Division of Pulmonary and Critical Care, Reading Health System, West Reading, PA, USA.
Int J Biomed Sci. 2014 Sep;10(3):217-20.
Amiodarone is one of the most frequently prescribed antiarrhythmic agents. Despite its widespread use, it is associated with systemic side effects. Pulmonary toxicity, the most severe adverse effect of amiodarone, has usually been described in the context of chronic amiodarone use. We report a case of an 80-year-old male presenting acutely following right upper lung lobe resection for stage 1b adenocarcinoma. He developed atrial fibrillation on postoperative day four and received 12.5 g of amiodarone within a 12 day period. On presentation, he had new bilateral lung opacities and a 35% absolute decline in the predicted diffusion capacity for carbon monoxide. Pulmonary embolism was ruled out on chest computed tomography. Amiodarone was discontinued and prednisone was initiated. Despite initial improvement, he suffered from multiple hypoxemic episodes until his death in the fourth month. In a subset of patients undergoing thoracic surgery who are intubated and require high levels of oxygen, the risk of amiodarone lung toxicity increases and patients may present acutely.
胺碘酮是最常用的抗心律失常药物之一。尽管其广泛应用，但它会引发全身性副作用。肺毒性是胺碘酮最严重的不良反应，通常在长期使用胺碘酮的情况下出现。我们报告一例80岁男性患者，因1b期腺癌接受右上肺叶切除术后急性发病。他在术后第4天出现房颤，并在12天内接受了12.5克胺碘酮治疗。就诊时，他出现新的双侧肺部混浊，预计一氧化碳弥散量绝对下降35%。胸部计算机断层扫描排除了肺栓塞。停用胺碘酮并开始使用泼尼松。尽管最初有所改善，但他在第四个月去世前多次出现低氧血症发作。在一部分接受胸外科手术且插管并需要高浓度氧气的患者中，胺碘酮肺毒性风险增加，患者可能急性发病。
