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Brief review: Angiotensin converting enzyme inhibitors and angioedema: anesthetic implications

Revue sommaire sur les implications anesthésiques de l’œdème de Quincke et des inhibiteurs de l’enzyme de conversion de l’ngiotensine

  • Published: October 2006
  • Volume 53, pages 994–1003, (2006)
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Canadian Journal of Anesthesia Aims and scope Submit manuscript
Brief review: Angiotensin converting enzyme inhibitors and angioedema: anesthetic implications
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  • Putul Sarkar1,
  • Grainne Nicholson1 &
  • George Hall1 

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  • 39 Citations

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Abstract

Purpose

Angiotensin converting enzyme inhibitors (ACEIs) are a group of drugs used to treat hypertension and heart failure, with additional benefits, such as cardiovascular and renal protection, in patients with diabetes. However, angioedema as a complication of ACEI therapy is under-recognized. As there are important implications for anesthesiologists and emergency medicine physicians, a review was undertaken to document the scope of the problem of ACEI-induced angioedema.

Methods

A review of the published literature (identified by searching Medline, EMBASE and CINAHL) was undertaken, addressing the clinical uses of ACEIs and the incidence, risk factors, pathophysiology, clinical presentation and management of angioedema associated with the use of these drugs.

Principal findings

The incidence of ACEI related angioedema has increased from 0.1-0.2% to 1% over the last decade. Patients who are receiving ACEIs are predisposed to developing angioedema which may be triggered by trauma, airway instrumentation, infection, and irritant fumes, particularly in those who are at increased risk. Cases of acute facial and airway oedema, due to ACEI drug administration, may be misdiagnosed as an anaphylactic reaction, and the association with ACEIs may be ignored. Some cases of intraoperative and postoperative airway edema may be precipitated by airway instrumentation in patients receiving ACEI drugs. The severity of airway compromise ranges from mild facial edema to severe laryngeal or subglottic edema which may prove life-threatening.

Conclusion

In view of the widespread clinical indications and ever-increasing use of ACEI drugs, the potentially life-threatening adverse reaction of ACEI-associated angioedema, and its treatment, must be recognized by anesthesiologists and all clinicians involved in airway management.

Résumé

Objectif

Les inhibiteurs de l’enzyme de conversion de l’angiotensine (IECA) sont utilisés contre l’hypertension et l’insuffisance cardiaque et aussi pour la protection cardiovasculaire et rénale, chez les patients diabétiques. L’œdème de Quincke est toutefois peu connu comme complication de l’usage des IECA. Cette situation ayant des répercussions sur le travail des anesthésiologistes et des urgentistes, une revue a été réalisée pour montrer l’étendue du problème de l’œdème de Quincke induit par l’IECA.

Méthode

Une revue des articles publiés (découverts dans Medline, EMBASE et CINAHL) a été faite en abordant les usages cliniques des IECA, l’incidence, les facteurs de risque, la physiopathologie, la présentation et le traitement cliniques de l’œdème de Quincke associés à ces médicaments.

Constatations principales

L’incidence d’œdème de Quincke relié aux IECA est passée 0,1–0,2% à 1 % pendant la dernière décennie. Les patients qui prennent des IECA sont prédisposés à l’œdème de Quincke qui peut être déclenché par un traumatisme, une exploration instrumentale, une infection et des émanations irritantes, surtout chez ceux qui sont à haut risque. L’œdème aigu du visage et des voies aériennes peut être diagnostiqué à tort comme une réaction anaphylactique et l’association avec les IECA restée inconnue. L’œdème peropératoire et postopératoire des voies aériennes peut dépendre de l’utilisation d’instruments dans les voies aériennes. La sévérité de l’atteinte peut être un léger œdème facial jusqu’à un œdème laryngé ou sous-glottique important et même très grave.

Conclusion

Dans l’optique des indications cliniques largement répandues, et en augmentation constante, de l’usage des IECA, la réaction indésirable et possiblement grave qu’est l’œdème de Quincke, et son traitement, doivent être connus des anesthésiologistes et de tous les cliniciens concernés par le contrôle des voies aériennes.

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References

  1. Slater EE, Merril DD, Guess HA, et al. Clinical profile of angioedema with angiotensin-converting enzyme inhibition. JAMA 1988, 260:967–70.

    Article  PubMed  CAS  Google Scholar 

  2. Sweitzer NK. What is an angiotensin converting enzyme inhibitor? Circulation 2003; 108:e16–8.

    Article  PubMed  Google Scholar 

  3. Brown NJ, Ray WA, Snowden M, Griffin MR. Black Americans have an increased rate of angiotensin converting enzyme inhibitor-associated angioedema. Clin Pharmacol Ther 1996; 60:8–13.

    Article  PubMed  CAS  Google Scholar 

  4. Vleeming W, van Amsterdam JG, Stricker BH, de Wildt DJ. ACE inhibitor-induced angioedema. Incidence, prevention and management. Drug Saf 1998; 18:171–88.

    Article  PubMed  CAS  Google Scholar 

  5. Gabb GM, Ryan P, Wing LM, Hutchinson KA. Epidemiological study of angioedema and ACE inhibitors. Aust N Z J Med 1996; 26:777–82.

    PubMed  CAS  Google Scholar 

  6. 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; 126:400–4.

    Article  PubMed  CAS  Google Scholar 

  7. Rai, MR, Amen F, Idrees F. Angiotensin-converting enzyme inhibitor related angioedema and the anaesthetist. Anaesthesia 2004; 59:283–9.

    Article  PubMed  CAS  Google Scholar 

  8. Megerian CA, Arnold JE, Berger M. Angioedema: 5 years’ experience, with a review of the disorder’s presentation and treatment. Laryngoscope 1992; 102:256–60.

    Article  PubMed  CAS  Google Scholar 

  9. Hedner T, Samuelsson O, Lunde H, Lindholm L, Andren L, Wiholm BE. Angio-oedema in relation to the treatment with angiotensin converting enzyme inhibitors. BMJ 1992; 304:941–6.

    Article  PubMed  CAS  Google Scholar 

  10. Pigman EC, Scott JL. Angioedema in the emergency department: the impact of angiotensin-converting enzyme inhibitors. Am J Emerg Med 1993; 11:350- 4.

    Article  PubMed  CAS  Google Scholar 

  11. Maier C. Life-threatening postoperative angioedema following treatment with an angiotensin converting enzyme inhibitor (German). Anaesthetist 1995; 44:875–9.

    Article  CAS  Google Scholar 

  12. O’Ryan F, Poor DB, Hattori M. Intraoperative angioedema induced by angiotensin-converting enzyme inhibitors: overview and case report. J Oral Maxillofac Surg 2005; 63:551–6.

    Article  PubMed  Google Scholar 

  13. Ogbureke KU, Cruz C, Johnson JV, Helfrick JF. Perioperative angioedema in a patient on long-term angiotensin-converting enzyme (ACE)-inhibitor therapy. J Oral Maxillofac Surg 1996; 54:917–20.

    Article  PubMed  CAS  Google Scholar 

  14. Jain M, Armstrong L, Hall J. Predisposition to and late onset of upper airway obstruction following angiotensin-converting enzyme inhibitor therapy. Chest 1992; 102:871–4.

    Article  PubMed  CAS  Google Scholar 

  15. Schiller PI, Messmer SL, Haefeli WE, Schlienger RG, Bircher AJ. Angiotensin-converting enzyme induced angioedema: late onset, irregular course, and potential role of triggers. Allergy 1997; 52:432–5.

    Article  PubMed  CAS  Google Scholar 

  16. Ulmer JL, Garvey MJ. Fatal angioedema associated with lisinopril. Ann Pharmacother 1992; 26:1245–6.

    PubMed  CAS  Google Scholar 

  17. Ducroix JP, Outurquin S, Benabes-Jezraoui B, et al. Angioedema and angiotensin converting enzyme inhibitors: a report of 19 cases (French). Rev Med Interne 2004; 25:501–6.

    PubMed  Google Scholar 

  18. Jason DR. Fatal angioedema associated with captopril. J Forensic Sci 1992; 37:1418–21.

    PubMed  CAS  Google Scholar 

  19. Oike Y, Ogata Y, Higashi D, Matsumura T, Numata Y. Fatal angioedema associated with enalapril. Intern Med 1993; 32:308–10.

    Article  PubMed  CAS  Google Scholar 

  20. Dean DE, Schultz DL, Powers RH. Asphyxia due to angiotensin converting enzyme (ACE) inhibitor mediated angioedema of the tongue during the treatment of hypertensive heart disease. J Forensic Sci 2001; 46:1239–43.

    PubMed  CAS  Google Scholar 

  21. Messerli FH, Nussberger J. Vasopeptidase inhibition and angio-oedema. Lancet 2000; 356:608–9.

    Article  PubMed  CAS  Google Scholar 

  22. Neutel JM. Effect of the renin-angiotensin system on the vessel wall: using ACE inhibition to improve endothelial function. J Hum Hypertens 2004; 18:599–606.

    Article  PubMed  CAS  Google Scholar 

  23. Anonymous. Effects of enalapril on mortality in severe congestive heart failure. Results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS). The CONSENSUS Trial Study Group. N Engl J Med 1987; 316: 1429–35.

  24. Anonymous. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. The SOLVD Investigators. N Engl J Med 1991; 325: 293–302.

  25. Cohn JN, Johnson G, Ziesche S, et al. A comparison of enalapril with hydralazine-isosorbide dinitrate in the treatment of chronic congestive heart failure. N Engl J Med 1991; 325, 303–10.

    PubMed  CAS  Google Scholar 

  26. Garg, R, Yusuf, S. Overview of randomized trials of angiotensin-converting enzyme inhibitors on mortality and morbidity in patients with heart failure. Collaborative Group on ACE Inhibitor Trials. JAMA 1995; 273:1450–6.

    Article  PubMed  CAS  Google Scholar 

  27. Pfeffer MA. ACE inhibition in acute myocardial infarction. N Engl J Med 1995; 332:118–20.

    Article  PubMed  CAS  Google Scholar 

  28. Elliott HL. Clinical use of angiotensin-converting enzyme inhibitors in patients with renal impairment. Blood Press Suppl 1994; 2:31–4.

    PubMed  CAS  Google Scholar 

  29. Bertrand ME. Provision of cardiovascular protection by ACE inhibitors: a review of recent trials. Curr Med Res Opin 2004; 20:1559–69.

    Article  PubMed  CAS  Google Scholar 

  30. Yosuf S, Sleight P, Pogue J, Borsch J, Davies R, Dagenais G. Effects of an angiotensin-converting- enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. The Heart Outcomes Prevention Evaluation Study Investigators. N Engl J Med 2000; 342:145–53.

    Article  Google Scholar 

  31. Hunt S, Baker DW, Chin MH, et al. ACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult: executive summary. A report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2001; 38:2101–13.

    Article  PubMed  CAS  Google Scholar 

  32. Anonymous. Failure to treat heart failure (Editorial). Lancet 1992; 339: 278–9.

  33. Cleland JG, Khand A, Clark A. The heart failure epidemic: exactly how big is it? Eur Heart J 2001; 22:623–6.

    Article  PubMed  CAS  Google Scholar 

  34. Montanaro D, Gropuzzo M, Tulissi P, et al. Renoprotective effect of early inhibition of the renin- angiotensin system in renal transplant recipients. Transplant Proc 2005; 37:991–3.

    Article  PubMed  CAS  Google Scholar 

  35. Bakris GL, Weir MR. Angiotensin-converting enzyme inhibitor-associated elevations in serum creatinine: is this a cause for concern? Arch Intern Med 2000; 160:685–93.

    Article  PubMed  CAS  Google Scholar 

  36. Bouvy ML, Heer dink ER, Hoes AW, Leufkens HG. Effects of NSAIDs on the incidence of hospitalisations for renal dysfunction in users of ACE inhibitors. Drug Saf 2003; 26:983–9.

    Article  PubMed  CAS  Google Scholar 

  37. Cziraky MJ, Mehr a IV, Wilson M, Bakris GL. Current issues in treating the hypertensive patient with diabetes: focus on diabetic nephropathy. Ann Pharmacother 1996; 30:791–801.

    PubMed  CAS  Google Scholar 

  38. Mogensen CE. Renoprotective role of ACE inhibitors in diabetic nephropathy. Br Heart J 1994; 72(3 Suppl):S38–45.

    Article  PubMed  CAS  Google Scholar 

  39. Rossing K, Jacobsen P, Pietraszek L, Parving HH. Renoprotective effects of adding angiotensin II receptor blocker to maximal recommended doses of ACE inhibitor in diabetic nephropathy: a randomized double-blind crossover trial. Diabetes Care 2003; 26:2268–74.

    Article  PubMed  CAS  Google Scholar 

  40. Rossing K, Christensen PK, Hansen BV, Carstensen B, Parving HH. Optimal dose of candesartan for renoprotection in type 2 diabetic patients with nephropathy: a double-blind randomized cross-over study. Diabetes Care 2003; 26:150–5.

    Article  PubMed  CAS  Google Scholar 

  41. Andersen S, Tarnow L, Rossing P, Hansen BV, Parving HH. Renoprotective effects of angiotensin II receptor blockade in type 1 diabetic patients with diabetic nephropathy. Kidney Int 2000; 57:601–6.

    Article  PubMed  CAS  Google Scholar 

  42. Strippoli GF, Craig M, Deeks JJ, Schena FP, Craig JC. Effects of angiotensin converting enzyme inhibitors and angiotensin II receptor antagonists on mortality and renal outcomes in diabetic nephropathy: systemic review. BMJ 2004; 329:828–38.

    Article  PubMed  CAS  Google Scholar 

  43. Anonymous. Effects of ramipril on cardiovascular and microvascular outcomes in people with diabetes mellitus: results of the HOPE study and MICRO-HOPE substudy. Heart Outcomes Prevention Evaluation Study Investigators. Lancet 2000; 355: 253–9.

  44. ACE Inhibitors in Diabetic Nephropathy Trialist Group. Should all patients with type 1 diabetes mellitus and microalbuminuria receive angiotensin-converting enzyme inhibitors? A meta-analysis of individual patient data. Ann Intern Med 2001; 134:370–9.

    Google Scholar 

  45. Brewster UC, Perazella MA. The renin-angiotensin- aldosterone system and the kidney: effects on kidneydisease. Am J Med 2004; 116:263–72.

    Article  PubMed  CAS  Google Scholar 

  46. Maschio G, Alberti D, Janin G, et al. Effect of the angiotensin-converting-enzyme inhibitor benazepril on the progression of chronic renal insufficiency. The Angiotensin-Converting-Enzyme Inhibition in Progressive Renal Insufficiency Study Group. N Engl J Med 1996; 334:939–45.

    Article  PubMed  CAS  Google Scholar 

  47. Anonymous. Randomised placebo-controlled trial of effect of ramipril on decline in glomerular filtration rate and risk of terminal renal failure in proteinuric, nondiabetic nephropathy. The GISEN Group. Lancet 1997; 349: 1857–63.

  48. Scheen AJ. Renin-angiotensin system inhibition prevents type 2 diabetes mellitus. Part 1. A meta-analysis of randomised clinical trials. Diabetes Metab 2004; 30:487–96.

    Article  PubMed  CAS  Google Scholar 

  49. Bohlen L, de Courten M, Weidmann P. Comparative study of the effect of ACE inhibitors and other antihypertensive agents on proteinuria in diabetic patients. Am J Hypertens 1994; 7(9 Pt 2):84S-92S.

    PubMed  CAS  Google Scholar 

  50. Lewis EJ, Hunsicker LG, Bain RP, Rohde RD. The effect of angiotensin-converting-enzyme inhibition on diabetic nephropathy. The Collaborative Study Group. N Engl J Med 1993; 329:1456–62.

    Article  PubMed  CAS  Google Scholar 

  51. Brown NJ, Agirbasli MA, Williams GH, Litchfield WR, Vaughan DE. Effect of activation and inhibition of the renin-angiotensin system on plasma PAI-1. Hypertension 1998; 32:965–71.

    PubMed  CAS  Google Scholar 

  52. Furuhashi M, Ura N, Higashiura K, et al. Blockade of the renin-angiotensin system increases adiponectin concentrations in patients with essential hypertension. Hypertension 2003; 42:76–81.

    Article  PubMed  CAS  Google Scholar 

  53. Sharma AM. Is there a rationale for angiotensin blockade in the management of obesity hypertension? Hypertension 2004; 44:12–9.

    Article  PubMed  CAS  Google Scholar 

  54. Arita Y, Kihara S, Ouchi N, et al. Paradoxical decrease of an adipose-specific protein, adiponectin, in obesity. Biochem Biophys Res Commun 1999; 257:79–83.

    Article  PubMed  CAS  Google Scholar 

  55. Yamauchi T, Kamon J, Waki H, et al. The fat-derived hormone adiponectin reverses insulin resistance associated with both lipoatrophy and obesity. Nat Med 2001; 7:941–6.

    Article  PubMed  CAS  Google Scholar 

  56. Okamoto Y, Kihara S, Ouchi N, et al. Adiponectin reduces atherosclerosis in apolipoprotein E-deficient mice. Circulation 2002; 106:2767–70.

    Article  PubMed  CAS  Google Scholar 

  57. Reid IA. Vasoactive peptides.In: Katzung BG (Ed.). Basic and Clinical Pharmaclogy, 9th ed. McGraw Hill; 2003.

  58. Jensen NF, Weiler JM. C1 esterase inhibitor deficiency, airway compromise, and anesthesia. Anesth Analg 1998; 87:480–8.

    Article  PubMed  CAS  Google Scholar 

  59. Rosen FS, Davis AE III. Deficiencies of C1 inhibitor. Best Pract Res Clin Gastroenterol 2005; 19:251–61.

    Article  PubMed  CAS  Google Scholar 

  60. Ishoo E, Shah UK, Grillone G A, StramJR, Fuleihan NS. Predicting airway risk in angioedema: staging system based on presentation. Otolaryngol Head Neck Surg 1999; 121:263–8.

    Article  PubMed  CAS  Google Scholar 

  61. Hill MD, Lye T, Moss H, et al. Hemi-orolingual angioedema and ACE inhibition after alteplase treatment of stroke. Neurology 2003; 13:1525–7.

    Google Scholar 

  62. Molinaro G, Gervais N, Adam A. Biochemical basis of angioedema associated with recombinant tissue plasminogen activator treatment: an in vitro experimental approach. Stroke 2002; 33:1712–6.

    Article  PubMed  CAS  Google Scholar 

  63. Agostoni A, Cicardi M. Drug-induced angioedema without urticaria. Drug Saf 2001; 24:599–606.

    Article  PubMed  CAS  Google Scholar 

  64. Israili ZH, Hall WD. Cough and angioneurotic edema associated with angiotensin-converting enzyme inhibitor therapy. A review of the literature and pathophysiology. Ann Intern Med 1992; 117:234–42.

    PubMed  CAS  Google Scholar 

  65. Kostis JB, Packer M, Black HR, Schmieder R, Henry D, Levy E. Omapatrilat and enalapril in patients with hypertension: the Omapatrilat Cardiovascular Treatment vs. Enalapril (OCTAVE) trial. Am J Hypertens 2004; 17:103–11.

    Article  PubMed  CAS  Google Scholar 

  66. Agah R, Bandi V, Guntupalli KK. Angioedema: the role of ACE inhibitors and factors associated with poor clinical outcome. Intensive Care Med 1997; 23:793–6.

    Article  PubMed  CAS  Google Scholar 

  67. Bielory L, Lee SS, Holland CL, Jaker M. Long-acting ACE inhibitor-induced angioedema. Allergy Proc 1992; 13:85–7.

    Article  PubMed  CAS  Google Scholar 

  68. Rees RS, Bergman J, Ramirez-Alexander R. Angioedema associated with lisinopril. Am J Emerg Med 1992; 10:321–2.

    Article  PubMed  CAS  Google Scholar 

  69. Guo W, Turlapaty P, Shen Y, et al. Clinical experience with perindopril in patients non responsive to previous antihypertensive therapy: a large US community trial. Am J Ther 2004; 11:199–205.

    Article  PubMed  Google Scholar 

  70. Schuster C, Reinhart WH, Hartmann K, Kuhn M. Angioedema induced by ACE inhibitors and angiotensin II-receptor antagonists: analysis of 98 cases (German). Schweiz Med Wochenschr 1999; 129:362–9.

    PubMed  CAS  Google Scholar 

  71. Wernze H. ACE inhibitor-induced angioedema: remarkable new perspectives for intensive care/emergency medicine (German). Anasthesiol Intensivmed Notfallmed Schmerzther 1998; 33:637–41.

    Article  PubMed  CAS  Google Scholar 

  72. Prisant LM. Angioneurotic edema. J Clin Hypertens (Greenwich) 2001; 3:262–3.

    Article  CAS  Google Scholar 

  73. Golden WE, Cleves MA, Heard JK, Brasher R, McKinney P, Johnston JC. Frequency and recognition of angiotensin-converting enzyme inhibitor-associated angioneurotic edema. Clin Perform Qual Health Care 1993; 1:205–7.

    PubMed  CAS  Google Scholar 

  74. Agostoni A, Cicardi M, Cugno M, Zingale LC, Gioffre D, Nussberger J. Angioedema due to angiotensin- converting enzyme inhibitors. Immunopharmacology 1999; 44:21–5.

    Article  PubMed  CAS  Google Scholar 

  75. Adams KF Jr. Pathophysiologic role of the renin- angiotensin-aldosterone and sympathetic nervous systems in heart failure. Am J Health-Syst Pharm 2004; 61(Suppl2):S4–13.

    PubMed  CAS  Google Scholar 

  76. Razis PA, Coulson IH, Gould TR, Findley IL. Acquired C1 esterase inhibitor deficiency. Anaesthesia 1986; 41:838–40.

    Article  PubMed  CAS  Google Scholar 

  77. Sabroe RA, Black AK. Angiotensin-converting enzyme (ACE) inhibitors and angio-oedema. Br J Dermatol 1997, 136:153–8.

    Article  PubMed  CAS  Google Scholar 

  78. Blais C Jr,Rouleau JL, Brown NJ, et al. Serum metabolism of bradykinin and des-Arg9-bradykinin in patients with angiotensin-converting enzyme inhibitor-associated angioedema. Immunopharmacology 1999; 43:293–302.

    Article  PubMed  CAS  Google Scholar 

  79. Molinaro G, Cugno M, Perez M, et al. Angiotensin- converting enzyme inhibitor-associated angioedema is characterized by a slower degradation of des- arginine(9)-bradykinin. J Pharmacol Exp Ther 2002; 303:232–7.

    Article  PubMed  CAS  Google Scholar 

  80. Steinbach O, Schweder R, Freitag B. C1-esterase inhibitor in ACE inhibitor-induced severe angioedema of the tongue (German). Anaesthesiol Reanim 2001; 26:133–7.

    PubMed  CAS  Google Scholar 

  81. Kleiner GI, Giclas P, Stadtmauer G, Cunningham-Rundles C. Unmasking of acquired autoimmune C1-inhibitor deficiency by an angiotensin-converting enzyme inhibitor. Ann Allergy Asthma Immunol 2001; 86:461–4.

    PubMed  CAS  Google Scholar 

  82. Bas M, Hoffmann TK, Bier H, Kojda G. Increased C- reactive protein in ACE-inhibitor-induced angioedema. Br J Clin Pharmacol 2005; 59:233–8.

    Article  PubMed  CAS  Google Scholar 

  83. Gibbs CR, Lip GY, Beevers DG. Angioedema due to ACE inhibitors: increased risk in patients of African origin. Br J Clin Pharmacol 1999; 48:861–5.

    Article  PubMed  CAS  Google Scholar 

  84. Abbosh J, Anderson JA, Levine AB, Kupin WL. Angiotensin converting enzyme inhibitor-induced angioedema more prevalent in transplant patients. Ann Allergy Asthma Immunol 1999; 82:473–6.

    PubMed  CAS  Google Scholar 

  85. Morimoto T, Gandhi TK, Fiskio JM, et al. An evaluation of risk factors for adverse drug events associated with angiotensin-converting enzyme inhibitors. J Eval Clin Pract 2004; 10:499–509.

    Article  PubMed  Google Scholar 

  86. Chiu AG, New kirk KA, Davidson BJ, Burningham AR, Krowiak EJ, Deeb ZE. Angiotensin-converting enzyme inhibitor-induced angioedema: a multicenter review and an algorithm for airway management. Ann Otol Rhinol Laryngol 2001; 110:834–40.

    PubMed  CAS  Google Scholar 

  87. Brown NJ, Snow den M, Griffin MR. Recurrent angiotensin-converting enzyme inhibitor-associated angioedema. JAMA 1997; 278:232–3.

    Article  PubMed  CAS  Google Scholar 

  88. Marceau F. Is there a role for bradykinin in the therapeutic and side effects of angiotensin-converting enzyme inhibitors? Can J Cardiol 1997, 13:187–94.

    PubMed  CAS  Google Scholar 

  89. Thompson T, Frable MA. Drug-induced, life threatening angioedema revisited. Laryngoscope 1993; 103(1 Pt 1):10–2.

    Google Scholar 

  90. Bentsianov BL, Parhiscar A, Azer M, Har-El G. The role of fiberoptic nasopharyngoscopy in the management of the acute airway in angioneurotic edema. Laryngoscope 2000; 110:2016–9.

    Article  PubMed  CAS  Google Scholar 

  91. Schmidt TD, McGrath KM. Angiotensin-converting enzyme inhibitor angioedema of the intestine: a case report and review of the literature. Am J Med Sci 2002; 324:106–8.

    Article  PubMed  Google Scholar 

  92. Mullins RJ, Shanahan TM, Dobson RT. Visceral angioedema related to treatment with an ACE inhibitor. Med J Aust 1996; 165:319–21.

    PubMed  CAS  Google Scholar 

  93. Cohen EG, Soliman AM. Changing trends in angioedema. Ann Otol Rhinol Laryngol 2001; 110:701–6.

    PubMed  CAS  Google Scholar 

  94. Cicardi M, Zingale LC, Bergamaschini L, Agostoni A. Angioedema associated with angiotensin-converting enzyme inhibitor use: outcome after switching to a different treatment. Arch Intern Med 2004; 164:910–3.

    Article  PubMed  Google Scholar 

  95. Warrier MR, Copilevitz CA, Dykewicz MS, Slavin RG. Fresh frozen plasma in the treatment of resistant angiotensin converting enzyme inhibitor angioedema. Ann Allergy Asthma Immunol 2004; 92:573–5.

    Article  PubMed  Google Scholar 

  96. Karim MY, Masood A. Fresh-frozen plasma as a treatment for life-threatening ACE-inhibitor angioedema. J Allergy Clin Immunol 2002; 109:370–1.

    Article  PubMed  Google Scholar 

  97. Pylypchuk GB. ACE inhibitor- versus angiotensin II blocker-induced cough and angioedema. Ann Pharmacother 1998; 32:1060–6.

    Article  PubMed  CAS  Google Scholar 

  98. Van Rijnsoever EW, Kwee-Zuiderwijk WJ, Feenstra J. Angioneurotic edema attributed to the use of losartan. Arch Intern Med 1998; 158:2063–5.

    Article  PubMed  Google Scholar 

  99. Chiu AG, Krowiak EJ, Deeb ZE. Angioedema associated with angiotensin II receptor antagonists: challenging our knowledge of angioedema and its etiology. Laryngoscope 2001; 111:1729–31.

    Article  PubMed  CAS  Google Scholar 

  100. Howes LG, Tran D. Can angiotensin receptor antagonists be used safely in patients with previous ACE inhibitor-induced angioedema? Drug Saf 2002; 25:73–6.

    Article  PubMed  CAS  Google Scholar 

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  1. Department of Anaesthesia and Intensive Care Medicine, St George’s Hospital Medical School, SW17 0RE, London, UK

    Putul Sarkar, Grainne Nicholson & George Hall

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Sarkar, P., Nicholson, G. & Hall, G. Brief review: Angiotensin converting enzyme inhibitors and angioedema: anesthetic implications. Can J Anesth 53, 994–1003 (2006). https://doi.org/10.1007/BF03022528

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  • Accepted: 29 May 2006

  • Issue Date: October 2006

  • DOI: https://doi.org/10.1007/BF03022528

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Keywords

  • Diabetic Nephropathy
  • Angiotensin Converting Enzyme
  • Angioedema
  • Angioneurotic Edema
  • Airway Intervention
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