Key result
Two patients developed diffuse alveolar hemorrhage following exposure to sevoflurane and warfarin, which resolved rapidly after drug discontinuation and supportive treatment.
Case Report (n=2)
Diffuse alveolar hemorrhage is a rare but potentially life-threatening complication of sevoflurane and warfarin that requires prompt recognition and management.
Prompt recognition and drug withdrawal may aid resolution of alveolar hemorrhage; case report leaves open causality and generalizability.
We present here two cases who developed diffuse alveolar hemorrhage (DAH) after using inhaled anesthetic sevoflurane and warfarin as an anticoagulant.The first patient was a 32-year-old male who underwent general surgery for appendicitis, and who developed sudden hypoxemia and bleeding at the end of the operation.Bilateral diffuse alveolar infiltrates were identified on chest X-ray, and decreased serum hemoglobin in the postoperative period.The hypoxemia resolved on the fifth day, and alveolar infiltrates disappeared from the chest X-ray.The second case was prescribed Coumadin for the treatment of atrial fibrillation and was found to have an INR value of 12.6 upon presentation to the emergency department with a complaint of hemoptysis.The patient was administered intramuscular vitamin K, and the pulmonary infiltrates were noted to have regressed radiologically on the fifth day.Although DAH is rare with both drugs, early diagnosis and treatment can be lifesaving.
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Kaplan et al. (2024) conducted a case report in Diffuse alveolar hemorrhage (n=2). Sevoflurane and Warfarin was evaluated on Development and resolution of diffuse alveolar hemorrhage. Two patients developed diffuse alveolar hemorrhage following exposure to sevoflurane and warfarin, which resolved rapidly after drug discontinuation and supportive treatment.
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