Pulmonary edema after intravenous ethchlorvynol (Placidyl)

Four patients had dyspnea, fever, tachycardia and hypotension within four hours of as little as 1000 mg ethchlorvynol self-administered intravenously. Pulmonary infiltrates with hypoxemia characteristic of pulmonary edema occurred in all, requiring intubation and mechanical ventilation in three. Pulmonary artery and wedge pressures measured in two by Swan-Gantz catheter were moderately increased. While all patients survived, all had shifts of third space fluid with recovery, mild rhabdomyalysis occurred in two and hemolysis was documented in one. When taken intravenously, ethchlorvynol in relatively low dose induces a type of adult respiratory distress syndrome (ARDS) that can be life-threatening.