Acute amiodarone-induced lung toxicity

The toxic effects of amiodarone on the lung are well recognised, but the rapid onset of those effects, especially in the presence of high inspired oxygen concentrations, are perhaps not adequately appreciated. This may be a potential problem in the Intensive Care Unit (ICU) where amiodarone is frequently used in the treatment of tachydysrhythmias in patients with acute respiratory distress syndrome (ARDS) requiring very high inspired oxygen concentrations. The finding of typical histological appearances of acute amiodarone pulmonary toxicity at post mortem examination of a patient thought to have died from ARDS prompted a review of post mortem findings in patients with a clinical diagnosis of ARDS over the last 3 years.