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opinions/hypotheses: Houman Ashrafian and Patrick Davey Is Amiodarone an Underrecognized Cause of Acute Respiratory Failure in the ICU? Chest 2001; 120: 275-282 [Abstract] [Full text] [PDF]

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Amiodarone and Respiratory Failure

Mohamed Y Rady   (16 July 2001)

Amiodarone and Respiratory Failure 16 July 2001
Mohamed Y Rady Send letter to journal: Re: Amiodarone and Respiratory Failure Rady.Mohamed{at}mayo.edu Mohamed Y Rady	I read your article " Is Amiodarone an Underrecognized Cause of Acute Respiratory Failure in the ICU? in (Chest. 2001;120:275-282.). There is no clinical evidence to support your current speculations nor your recommendation on the use of amiodarone in cardiac surgey patient. In fact, it one of the safest anti-arrthymic agents to use in the critically ill patients. In our experience, we have used this agent successfully for prevention and treatment of tachy-arrhtymia after cardiac surgery as well in other surgical and medical patients with acute lung injury in the ICU without any adverse effects. Acute respiratory failure and acute lung after cardiac surgey are multifactorial, and it also easy and tempting to be oversimplicstic and blame it on a single agent or drug . I would refer you to some pertient clincial studies published after cardiac surgey, which in fact contradicts your recent hypothesis and practice recommendations. References: 1) MY Rady, TA Ryan, NJ Starr . Preoperative Therapy with amiodarone and the incidence of acute organ dysfunction after cardiac surgery. Anesthesia & Analgesia 1997; 85:489-97. 2) MY Rady, T Ryan, NJ Starr. Early onset of acute pulmonary dysfunction after cardiovascular surgery: risk factors and clinical outcome. Crit Care Med1997; 25:1831-1839 3)MY Rady, TA Ryan. Peri-operative predictors of extubation failure and the effect on clinical outcome after cardiac surgery. Crit Care Med 1999; 27:340-347. Mohamed Y Rady MD PhD Associate Professor of Medicine Department of Critical Care Medicine Mayo Clinic Hospital 5777 East Mayo Blvd, Phoenix, AZ 85054, USA