Document Detail


Vasopressin for the management of catecholamine-resistant anaphylactic shock.
MedLine Citation:
PMID:  18830525     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Severe anaesthetic anaphylaxis is relatively uncommon. Oxygen, fluids and epinephrine are considered to be the mainstay for treatment of cardiovascular collapse and current guidelines for the management of anaphylaxis list only epinephrine as a vasopressor to use in the event of a cardiovascular collapse. Recently, evidence has emerged in the support of the use of vasopressin in cardiopulmonary resuscitation; it is also recommended for the treatment of ventricular fibrillation, septic shock and post-cardiopulmonary bypass distribution shock. Currently, there is no algorithm or guideline for the management of anaphylaxis that include the use of vasopressin. We report a 24-year-old woman who developed severe anaphylactic shock at induction of anaesthesia while undergoing laparoscopic cholecystectomy. Circulation shock was refractory to epinephrine and high doses of pure alpha-agonist phenylephrine and norepinephrine. Single intravenous dose of two units of vasopressin re-established normal circulation and blood pressure.
Authors:
A M Hussain; B Yousuf; M A Khan; F H Khan; F A Khan
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Singapore medical journal     Volume:  49     ISSN:  0037-5675     ISO Abbreviation:  Singapore Med J     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-10-02     Completed Date:  2009-07-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0404516     Medline TA:  Singapore Med J     Country:  Singapore    
Other Details:
Languages:  eng     Pagination:  e225-8     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Aga Khan University Hospital, Stadium Road, PO Box 3500, Karachi 74800, Pakistan. aziza.mohammad@aku.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Algorithms
Anaphylaxis / chemically induced*,  drug therapy*
Blood Pressure
Catecholamines / therapeutic use*
Cholecystectomy / methods
Drug Resistance
Epinephrine / pharmacology
Female
Humans
Norepinephrine / pharmacology
Phenylephrine / pharmacology
Treatment Outcome
Vasoconstrictor Agents / therapeutic use*
Vasopressins / therapeutic use*
Chemical
Reg. No./Substance:
0/Catecholamines; 0/Vasoconstrictor Agents; 11000-17-2/Vasopressins; 51-41-2/Norepinephrine; 51-43-4/Epinephrine; 59-42-7/Phenylephrine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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