1
|
Saeed O, Farooq M, Chinnadurai T, Ramos J, Patel S, Chavez P, Rochlani Y, Murthy S, Shin J, Vukelic S, Sims D, Goldstein D, Jorde U. Platelet Function and Sildenafil Use During Left Ventricular Assist Device Support. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
|
2
|
Patel SR, Vukelic S, Chinnadurai T, Madan S, Sibinga N, Kwah J, Saeed O, Goldstein DJ, Jorde UP. Gastrointestinal angiodysplasia in heart failure and during CF LVAD support. J Heart Lung Transplant 2021; 41:129-132. [PMID: 34911655 DOI: 10.1016/j.healun.2021.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 10/20/2021] [Accepted: 11/10/2021] [Indexed: 01/20/2023] Open
Abstract
Angiodysplasias (AGD) are common sites of bleeding in the gastrointestinal (GI) tract after Continuous Flow Left Ventricular Assist Device (CF-LVAD) implantation. We sought to investigate whether AGDs are formed as a result of LVAD physiology or preexist as a consequence of heart failure. Thirty-six subjects with HF reduced EF (HFrEF) underwent video capsule endoscopy (VCE) to assess for the presence of AGD. Fifty-three subjects without HF who underwent VCE for a nonbleeding indication formed a control group. The prevalence of AGD was significantly higher in the HFrEF compared to the non-HF controls (50% vs 13%, p = 0.0002). This association persisted after controlling for age and comorbidities. Within the HFrEF cohort, higher Ang2, NT-proBNP and BUN were associated with the presence of AGD. AGD in the GI tract are associated with HFrEF. This is the first description of a new pathology associated with HFrEF and adds to our understanding of CF LVAD associated GI bleeding.
Collapse
Affiliation(s)
- Snehal R Patel
- Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
| | - Sasha Vukelic
- Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Thiru Chinnadurai
- Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Shivank Madan
- Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Nicholas Sibinga
- Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Joann Kwah
- Division of Gastroenterology, Department of Medicine, New York University, New York, New York
| | - Omar Saeed
- Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Daniel J Goldstein
- Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Ulrich P Jorde
- Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| |
Collapse
|
3
|
Milwidsky A, Haroun M, Saeed O, Goldstein D, Forest S, Uehara M, Chinnadurai T, Madan S, Jorde U. Post Left Ventricular Assist Device Implantation Platelets Count Alterations are Related to Gender, Race and Early Mortality. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
4
|
Alvarez Villela M, Chinnadurai T, Salkey K, Furlani A, Yanamandala M, Vukelic S, Sims DB, Shin JJ, Saeed O, Jorde UP, Patel SR. Feasibility of high-intensity interval training in patients with left ventricular assist devices: a pilot study. ESC Heart Fail 2020; 8:498-507. [PMID: 33205573 PMCID: PMC7835573 DOI: 10.1002/ehf2.13106] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 10/03/2020] [Accepted: 10/22/2020] [Indexed: 01/27/2023] Open
Abstract
Aims Patients with left ventricular assist device (LVAD) suffer from persistent exercise limitation despite improvement of their heart failure syndrome. Exercise training (ET) programmes to improve aerobic capacity have shown modest efficacy. High‐intensity interval training (HIIT), as an alternative to moderate continuous training, has not been systematically tested in this population. We examine the feasibility of a short, personalized HIIT programme in patients with LVAD and describe its effects on aerobic capacity and left ventricular remodelling. Methods and results Patients on durable LVAD support were prospectively enrolled in a 15‐session, 5 week HIIT programme. Turndown echocardiogram, Kansas City Cardiomyopathy Questionnaire, and cardiopulmonary exercise test were performed before and after HIIT. Training workloads for each subject were based on pretraining peak cardiopulmonary exercise test work rate (W). Percentage of prescribed training workload completed and adverse events were recorded for each subject. Fifteen subjects were enrolled [10 men, age = 51 (29–71) years, HeartMate II = 12, HeartMate 3 = 3, and time on LVAD = 18 (3–64) months]. Twelve completed post‐training testing. HIIT was well tolerated, and 90% (inter‐quartile range: 78, 99%) of the prescribed workload (W) was completed with no major adverse events. Improvements were seen in aV̇O2 at ventilatory threshold [7.1 (6.5, 9.1) to 8.5 (7.7, 9.3) mL/kg/min, P = 0.04], work rate at ventilatory threshold [44 (14, 54) to 55 (21, 66) W, P = 0.05], and left ventricular end‐diastolic volume [168 (144, 216) to 159 (124, 212) mL, n = 7, P = 0.02]. HIIT had no effect on maximal oxygen consumption (V̇O2peak) or Kansas City Cardiomyopathy Questionnaire score. Conclusions Cardiopulmonary exercise test‐guided HIIT is feasible and can improve submaximal aerobic capacity in stable patients with chronic LVAD support. Further studies are needed on its effects on the myocardium and its potential role in cardiac rehabilitation programmes.
Collapse
Affiliation(s)
- Miguel Alvarez Villela
- Department of Medicine, Montefiore Einstein Center for Heart and Vascular Care, New York, NY, USA.,Division of Cardiology, Department of Medicine, Jacobi Medical Center, New York, NY, USA
| | - Thiru Chinnadurai
- Department of Medicine, Montefiore Einstein Center for Heart and Vascular Care, New York, NY, USA
| | - Kalil Salkey
- Department of Medicine, Montefiore Einstein Center for Heart and Vascular Care, New York, NY, USA
| | - Andrea Furlani
- Department of Medicine, Montefiore Einstein Center for Heart and Vascular Care, New York, NY, USA
| | - Mounica Yanamandala
- Brigham and Women's Hospital, Heart and Vascular Center, Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Sasha Vukelic
- Department of Medicine, Montefiore Einstein Center for Heart and Vascular Care, New York, NY, USA
| | - Daniel B Sims
- Department of Medicine, Montefiore Einstein Center for Heart and Vascular Care, New York, NY, USA
| | - Jooyoung J Shin
- Department of Medicine, Montefiore Einstein Center for Heart and Vascular Care, New York, NY, USA
| | - Omar Saeed
- Department of Medicine, Montefiore Einstein Center for Heart and Vascular Care, New York, NY, USA
| | - Ulrich P Jorde
- Department of Medicine, Montefiore Einstein Center for Heart and Vascular Care, New York, NY, USA
| | - Snehal R Patel
- Department of Medicine, Montefiore Einstein Center for Heart and Vascular Care, New York, NY, USA
| |
Collapse
|
5
|
Kumar S, Rashid S, Mustehasan M, Chinnadurai T, Gupta N, Saeed O, Patel S, Murthy S, Shin J, Forest S, Vukelic S, Goldstein D, Jorde U, Sims D. Maximum Vasoactive Inotropic Score in the 48 Hours Post-LVAD Implantation Correlates with Early Severe Right Ventricular Failure. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
6
|
Saeed O, Jakobleff WA, Forest SJ, Chinnadurai T, Mellas N, Rangasamy S, Xia Y, Madan S, Acharya P, Algodi M, Patel SR, Shin J, Vukelic S, Sims DB, Reyes Gil M, Billett HH, Kizer JR, Goldstein DJ, Jorde UP. Hemolysis and Nonhemorrhagic Stroke During Venoarterial Extracorporeal Membrane Oxygenation. Ann Thorac Surg 2019; 108:756-763. [PMID: 30980824 PMCID: PMC6708732 DOI: 10.1016/j.athoracsur.2019.03.030] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 01/24/2019] [Accepted: 03/07/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND Hemolysis, even at low levels, activates platelets to create a prothrombotic state and is common during mechanical circulatory support. We examined the association of low-level hemolysis (LLH) and nonhemorrhagic stroke during venoarterial extracorporeal membrane oxygenation (VA ECMO) support. METHODS A single-center retrospective review of all adult patients placed on VA ECMO from January 2012 to September 2017 was conducted. To determine the association between LLH and nonhemorrhagic stroke, patients were categorized as those with and without LLH. LLH was defined by 48-hour plasma free hemoglobin (PFHb) of 11 to 50 mg/dL after VA ECMO implantation. RESULTS Of 201 patients who underwent VA ECMO placement, 150 (75%) met inclusion criteria and comprised the study population. They were 55 ± 14 years of age and 50 (33%) were women. Sixty-two (41%) patients had LLH. Patients with LLH had a higher likelihood of incident nonhemorrhagic stroke during VA ECMO support (20 [32%] versus 4 [5%]; adjusted hazard ratio [HR], 7.6; 95% confidence interval [CI], 2.2 to 25.9; p = 0.001). The severity of LLH was associated with an incrementally higher likelihood of a nonhemorrhagic stroke (PFHb 26 to 50 mg/dL: HR, 11.3; 95% CI, 3.6 to 35.1; p = 0.001; PFHb 11 to 25 mg/dL: HR, 4.4; 95% CI, 1.36 to 14.85; p = 0.014) in comparison with no LLH. Those with LLH had a 2-fold greater increase in mean platelet volume after VA ECMO placement (0.98 ± 1.1 fL versus 0.49 ± 0.96 fL; p = 0.03). Patients with a nonhemorrhagic stroke had a higher operative mortality (20 [83%] versus 57 [45%]; adjusted HR, 3.1; 95% CI, 1.8 to 5.3; p < 0.001). CONCLUSIONS Hemolysis at low levels during VA ECMO support is associated with subsequent nonhemorrhagic stroke.
Collapse
Affiliation(s)
- Omar Saeed
- Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
| | - William A Jakobleff
- Department of Cardiothoracic and Vascular Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Stephen J Forest
- Department of Cardiothoracic and Vascular Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Thiru Chinnadurai
- Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Nicolas Mellas
- Department of Cardiothoracic and Vascular Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Sabarivinoth Rangasamy
- Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Yu Xia
- Department of Cardiothoracic and Vascular Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Shivank Madan
- Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Prakash Acharya
- Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Mohammad Algodi
- Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Snehal R Patel
- Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Julia Shin
- Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Sasa Vukelic
- Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Daniel B Sims
- Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Morayma Reyes Gil
- Department of Pathology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Henny H Billett
- Division of Hematology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Jorge R Kizer
- Section of Cardiology, San Francisco Veterans Affairs Health Care System, San Francisco, California; Department of Medicine, University of California, San Francisco, San Francisco, California; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
| | - Daniel J Goldstein
- Department of Cardiothoracic and Vascular Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Ulrich P Jorde
- Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| |
Collapse
|
7
|
Chinnadurai T, Hanif W, Patel S, Sims D, Saeed O, Murthy S, Shin J, Vukelic S, Forest S, Jakobleff W, Goldstein D, Jorde U. The Interaction of Amiodarone and LVAD in Severe Primary Graft Dysfunction. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
8
|
Chinnadurai T, Jahufar F, Moussa O, Rahman A, Rangasamy S, Borukhov E, Miller A, Saeed O, Goldstein D, Jorde U, Patel S. Risk Factors and Early Outcomes of Vasoplegia Syndrome (VS) after Heart Transplantation in CF-LVAD Patients. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
9
|
Villela MA, Chinnadurai T, Furlani A, Salkey K, Shin J, Drakos S, Jorde U, Patel S. High-Intensity Interval Training Induces Reverse Left Ventricular Remodeling in Patients with LVAD. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.1165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
10
|
Vukelic S, Vlismas PP, Patel SR, Xue X, Shitole SG, Saeed O, Sims DB, Chinnadurai T, Shin JJ, Forest SJ, Goldstein DJ, Jorde UP. Digoxin Is Associated With a Decreased Incidence of Angiodysplasia-Related Gastrointestinal Bleeding in Patients With Continuous-Flow Left Ventricular Assist Devices. Circ Heart Fail 2018; 11:e004899. [DOI: 10.1161/circheartfailure.118.004899] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Sasa Vukelic
- Division of Cardiology, Department of Medicine (S.V., P.P.V., S.R.P., S.G.S., O.S., D.B.S., T.C., J.J.S., U.P.J.)
| | - Peter P. Vlismas
- Division of Cardiology, Department of Medicine (S.V., P.P.V., S.R.P., S.G.S., O.S., D.B.S., T.C., J.J.S., U.P.J.)
| | - Snehal R. Patel
- Division of Cardiology, Department of Medicine (S.V., P.P.V., S.R.P., S.G.S., O.S., D.B.S., T.C., J.J.S., U.P.J.)
| | - Xiaonan Xue
- Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (X.X.)
| | - Sanyog G. Shitole
- Division of Cardiology, Department of Medicine (S.V., P.P.V., S.R.P., S.G.S., O.S., D.B.S., T.C., J.J.S., U.P.J.)
| | - Omar Saeed
- Division of Cardiology, Department of Medicine (S.V., P.P.V., S.R.P., S.G.S., O.S., D.B.S., T.C., J.J.S., U.P.J.)
| | - Daniel B. Sims
- Division of Cardiology, Department of Medicine (S.V., P.P.V., S.R.P., S.G.S., O.S., D.B.S., T.C., J.J.S., U.P.J.)
| | - Thiru Chinnadurai
- Division of Cardiology, Department of Medicine (S.V., P.P.V., S.R.P., S.G.S., O.S., D.B.S., T.C., J.J.S., U.P.J.)
| | - Julia J. Shin
- Division of Cardiology, Department of Medicine (S.V., P.P.V., S.R.P., S.G.S., O.S., D.B.S., T.C., J.J.S., U.P.J.)
| | | | | | - Ulrich P. Jorde
- Division of Cardiology, Department of Medicine (S.V., P.P.V., S.R.P., S.G.S., O.S., D.B.S., T.C., J.J.S., U.P.J.)
| |
Collapse
|
11
|
Alvarez Villela M, Chinnadurai T, Salkey K, Furlani A, Yanamandala M, Luke A, Castillo C, Taveras M, Sims D, Saeed O, Shin J, Pina I, Jorde U, Patel S. High-Intensity Interval Training Improves Exercise Performance in Patients with LVAD. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
|
12
|
Patel S, Kwah J, Rosenberg H, Chinnadurai T, Saeed O, Gibber M, Goldstein D, Jorde U. Angiodysplastic Lesions in the Gastrointestinal Tract of Heart Failure Patients Predates Post LVAD Bleeding. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
13
|
Chinnadurai T, Patel S, Sims D, Saeed O, Shin J, Madan S, Hanif W, Vukelic S, Borukhov E, Forest S, Rahmanian M, Carlese A, Leung S, Jakobleff W, Goldstein D, Jorde U. Primary Graft Failure is More Common in Patients Bridged to Heart Transplant with LVAD: Role of Early Peripheral ECMO. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
|
14
|
Luke A, Castillo C, Taveras M, Chinnadurai T, Rangasamy S, Goldstein D, Jorde U, Patel S. IPADS and LVADS: VAD Coordinator Telemonitoring. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
15
|
Villela MA, Salkey K, Chinnadurai T, Yanamandala M, Shin J, Pina I, Jorde U, Patel S. SHORT-TERM REPRODUCIBILITY OF CARDIOPULMONARY EXERCISE TEST PARAMETERS IN PATIENTS WITH LEFT VENTRICULAR ASSISTIVE DEVICE. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)31515-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
16
|
Chinnadurai T, Madan S, Patel SR, Jorde UP. Low ejection fraction in donor hearts is not directly associated with increased recipient mortality. J Heart Lung Transplant 2017; 37:426. [PMID: 28864338 DOI: 10.1016/j.healun.2017.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 07/28/2017] [Accepted: 08/09/2017] [Indexed: 11/25/2022] Open
Affiliation(s)
- Thiru Chinnadurai
- Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
| | - Shivank Madan
- Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Snehal R Patel
- Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Ulrich P Jorde
- Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| |
Collapse
|
17
|
Abstract
BACKGROUND This case report describes inhalation fever as an uncommon pulmonary adverse effect of synthetic cannabinoids. CASE REPORT A 29-year-old man was brought in for severe agitation after smoking K2, a synthetic cannabinoid. He required multiple doses of lorazepam and haloperidol for sedation. His vital signs were notable for a mild fever and tachycardia. Otherwise, the rest of his exam was unremarkable. The laboratory test was significant for leucocytosis and diffuse reticular-nodular and interstitial infiltrates on chest radiograph. Urine drug toxicology was negative. Interestingly, his symptoms and pulmonary infiltrates on the chest radiograph resolved spontaneously after 24 hours of observation. CONCLUSIONS This patient developed transient pulmonary infiltrates and fever following the synthetic cannabinoid inhalation, as seen in self-limiting inhalation fever. Inhalation fever as a consequence of synthetic cannabinoid has not been described previously and there is a need for further research in this field.
Collapse
Affiliation(s)
- Thiru Chinnadurai
- Department of Medicine, Harlem Hospital Center in affiliation with Columbia University College of Physician and Surgeons, New York, NY, USA
| | - Srijan Shrestha
- Department of Medicine, Harlem Hospital Center in affiliation with Columbia University College of Physician and Surgeons, New York, NY, USA
| | - Raji Ayinla
- Department of Medicine, Harlem Hospital Center in affiliation with Columbia University College of Physician and Surgeons, New York, NY, USA
| |
Collapse
|