DIFFUSE ALVEOLAR DAMAGE COMPLICATING ELECTROCONVULSIVE THERAPY

TOPIC: Diffuse Lung Disease TYPE: Fellow Case Reports INTRODUCTION: Electroconvulsive therapy (ECT) has been increasingly used over the last few years for various indications, of rare complications described in literature is pulmonary edema, only 9 case reports this complication, 8 which were attributed to none cardiogenic cause and one had a cardiology component. Here we present edema diffuse alveolar damage (DAD) with hemorrhage no cardiac component CASE PRESENTATION: 41 old female smoker, known have fibromyalgia, systemic lupus erythematosus (SLE) remission years, diabetes severe bipolar disorder refractory medical therapy' Patient admitted hospital ECT, shortly after procedure she developed hemoptysis shortness breath requiring oxygen therapy, chest tomography ruled out embolism but showed evidence process ground glass pacification (Image 2). inhaled medications anesthesia other inhalational injuries by history, also vasculitis infectious out. bronchoscopy suggestive DAD 1). review patient's report variation vital signs during ECHO was within normal. patient recovered supportive care advised be intubated on subsequent sessions DISCUSSION: None as complication while most cases describe it subsequence blood pressure result variation. The theory explain development / explained partially paralyzed diaphragm (Paralytic smaller dose are that doesn't complete paralysis aimed short minimal sedation) contract against close epiglottis abducted vocal cords from ECT current. This will negative inside cavity shearing force resulting small vessels extravasation plasma into space, our patient. Other contributory causes recurrence not common precautions warranted. noncardiogenic contraindication further sessions. CONCLUSIONS: being widely new modality psychiatric diseases, possible warranted, or post should raise suspension damage. treatment diuretics first line. therapies described. warranted following contraindicate them. REFERENCE #1: Manne JR, Kasirye Y, Epperla N, Garcia-Montilla RJ. Non-cardiogenic complicating electroconvulsive therapy: pathophysiology diagnostic approach. Clin Med Res. 2012 Aug;10(3) 131-136. doi:10.3121/cmr.2011.1030. PMID: 22031475; PMCID: PMC3421372. #2: Hatta K, Kitajima A, Ito M, Usui C, Arai H. Pulmonary treated long-standing asthma beta2 stimulant. J ECT. 2007 Mar;23(1) 26-27. doi:10.1097/01.yct.0000263258.52162.63. 17435570. #3: Myers, Christopher & Gopalka, Ajay Glick, David Goldman, Morris Dinwiddie, Stephen. (2008). A Negative-Pressure Edema After Therapy. journal 23. 281-3. 10.1097/yct.0b013e3180de5d44. DISCLOSURES: No relevant relationships Amro Alastal, source=Web Response Rami Batarseh, Lipinski,