Abstract
Angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists are known to be associated with angioedema. These drugs are widely prescribed for hypertension and left ventricular dysfunction, in accordance with NICE guidance. There have been several case series published pertaining to angioedema associated with antihypertensives originating from allergy clinics and emergency departments, but very few from critical care. We present a case series describing the presentation and critical care management of this group of patients. We found that 5 of 16 (31%) patients required tracheal intubation, with only one of these having an awake fibreoptic intubation. Fifteen out of 16 (94%) of these patients survived to hospital discharge. Previous authors have suggested that these patients should always be managed with awake fibreoptic intubation. Our data, although with limited numbers, challenge this approach.