Unexpected difficult airway management due to the use of ACE inhibitors: case report

  • Carmen Truyols a. Anaesthesiology and Resuscitation Service, Hospital El Escorial, Madrid, Spain. b. Faculty of Health Sciencies, Universidad Francisco de Vitoria (UFV), Pozuelo de Alarcón, Spain.
  • Carlos Díaz Anaesthesiology and Resuscitation Service, Hospital El Escorial, Madrid, Spain.
  • Luis Brito Anaesthesiology and Resuscitation Service, Hospital El Escorial, Madrid, Spain.
  • María García-Ramiro Anaesthesiology and Resuscitation Service, Hospital El Escorial, Madrid, Spain.
Keywords: Airway Management, Angioedema, Captopril, Anaphylaxis, Case Reports

Abstract

Angioedema induced by the use of angiotensin converting enzyme (ACE) inhibitors is an uncommon but life-threatening complication, especially when the airway is affected, creating unexpected difficult airway management.

A prompt differential diagnosis with anaphylactic shock is critical, given that adrenaline treatment does not improve angioedema.

We report a case of angioedema induced by ACE inhibitor following in-hospital administration of captopril, with almost impossible intubation, and secondary aspiration during airway management. Angioedema was erroneously treated, because it was mistakenly considered to be an anaphylactic reaction, and it could have ended in death.

References

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2. Sondhi D, Lippmann M, Murali G. Airway compromise due to angiotensin-converting enzyme inhibitor-induced angioedema: Clinical experience at a large community teaching hospital. Chest 2004;126:400-404.

3. Toh S, Reichman ME, Houstoun M, et al. Comparative risk for angioedema associated with the use of drugs that target the renin-angiotensin-aldosterone system. Arch Intern Med 2012;172:1582-1589.

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10. 10. Illing EJ, Kelly S, Hobson JC, et al. Icatibant and ACE inhibitor angioedema. BMJ Case Rep 2012;30: doi: 10.1136/bcr-2012-006646.
How to Cite
1.
Truyols C, Díaz C, Brito L, García-Ramiro M. Unexpected difficult airway management due to the use of ACE inhibitors: case report. Colomb. J. Anesthesiol. [Internet]. 2018 Jul. 1 [cited 2024 Mar. 29];46(3):264-7. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/548

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Published
2018-07-01
How to Cite
1.
Truyols C, Díaz C, Brito L, García-Ramiro M. Unexpected difficult airway management due to the use of ACE inhibitors: case report. Colomb. J. Anesthesiol. [Internet]. 2018 Jul. 1 [cited 2024 Mar. 29];46(3):264-7. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/548
Section
Case Report / Case Series

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