Table of Contents Author Guidelines Submit a Manuscript
Case Reports in Critical Care
Volume 2018, Article ID 8081607, 6 pages
https://doi.org/10.1155/2018/8081607
Case Report

Icatibant for Angiotensin-Converting Enzyme Inhibitor-Induced Angioedema in Intubated Patients: Case Series and Literature Review

1Department of Pharmacy Services, South Texas Veterans Health Care System, 7400 Merton Minter, San Antonio, TX 78229, USA
2Pharmacotherapy Education & Research Center, The University of Texas Health San Antonio, 7703 Floyd Curl Dr., MSC 6220, San Antonio, TX 78229-3900, USA
3Medicine Service, Pulmonary/Critical Care Division, South Texas Veterans Health Care System, 7400 Merton Minter (111E), San Antonio, TX 78229, USA
4Department of Medicine, Pulmonary/Critical Care Division, The University of Texas Health San Antonio, 7703 Floyd Curl Dr., MSC 7885, San Antonio, TX 78229-3900, USA

Correspondence should be addressed to Erin K. Yeung; moc.liamg@gnueyknire

Received 31 August 2017; Revised 7 December 2017; Accepted 6 February 2018; Published 4 March 2018

Academic Editor: Natale Daniele Brunetti

Copyright © 2018 Erin K. Yeung et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. A case series of icatibant use in intubated patients with angiotensin-converting enzyme inhibitor- (ACEI-) induced angioedema is presented along with a relevant literature review and recommendations for utilization. Summary. Three intubated patients admitted to the intensive care unit for ACEI-induced angioedema were treated with icatibant. A literature search identified one controlled study and four case reports describing the use of icatibant in intubated ACEI-induced angioedema patients. Conclusion. Icatibant administration in intubated patients may be beneficial in decreasing time to extubation and length of intensive care unit stay. In the three cases described, icatibant administration did not appear to elicit a response in intubated patients, which has been described in previous case reports. For clinicians considering icatibant in the treatment of ACEI-induced angioedema, earlier administration upon arrival to the ED or immediately upon arriving to the intensive care unit is strongly advised. The suggested benefit of icatibant in intubated ACEI-induced angioedema patients should be verified by randomized clinical trials and cost-benefit analyses should be performed at individual institutions.