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The Drug-Induced Respiratory Disease Website

Philippe Camus, M.D.

Dijon, France

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Protamine

2

II.a Pulmonary edema, noncardiogenic (NCPE)

1
Last update : 13/09/2012
 
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Identify causative drugs
Diagnosing DIRD
1
Drug and radiation history
2
Drug singularity - Correct identification of the drug
3
Consistent timing of exposure v. onset of symptoms
4
Clinical, imaging, BAL, pathological pattern consistent with the specific drug
5
Careful exlusion of another cause
6
Remission of symptoms with removal of drug
7
Recurrence with rechallenge (rarely advisable)
8
Causality assessment
More detailed checklist

Publications

Noncardiogenic pulmonary edema immediately following rapid protamine administration.
The Annals of pharmacotherapy 1999 Sep;33;927-30 1999 Sep
Noncardiogenic pulmonary edema and rhabdomyolsis after protamine administration in a patient with unrecognized McArdle's disease.
Anesthesiology 1999 Jul;91;303-5 1999 Jul
Protamine-induced fulminating non-cardiogenic pulmonary edema following cardiopulmonary bypass.
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery 1996;10;463-6 1996

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