Báo cáo y học: Role of vasopressin in the treatment of anaphylactic shock in a child undergoing surgery for congenital heart disease: a case report

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Role of vasopressin in the treatment of anaphylactic shock in a child undergoing surgery for congenital heart disease: a case report...
Nội dung trích xuất từ tài liệu:
Báo cáo y học: "Role of vasopressin in the treatment of anaphylactic shock in a child undergoing surgery for congenital heart disease: a case report"Journal of Medical Case Reports BioMed Central Open AccessCase reportRole of vasopressin in the treatment of anaphylactic shock in a childundergoing surgery for congenital heart disease: a case reportLuca Di Chiara, Giulia V Stazi, Zaccaria Ricci*, Angelo Polito,Stefano Morelli, Chiara Giorni, Ondina La Salvia, Vincenzo Vitale,Eugenio Rossi and Sergio PicardoAddress: Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Hospital, Rome, ItalyEmail: Luca Di Chiara - dichiaraluca@libero.it; Giulia V Stazi - giuliavaleria@tiscali.it; Zaccaria Ricci* - z.ricci@libero.it;Angelo Polito - angpolito@hotmail.com; Stefano Morelli - s.zeus@inwind.it; Chiara Giorni - c_giorni@yahoo.it; Ondina LaSalvia - dichiaraluca@libero.it; Vincenzo Vitale - ezio.vitale@tin.it; Eugenio Rossi - rossi@opbg.net; Sergio Picardo - picardo@opbg.net* Corresponding authorPublished: 5 February 2008 Received: 4 August 2007 Accepted: 5 February 2008Journal of Medical Case Reports 2008, 2:36 doi:10.1186/1752-1947-2-36This article is available from: http://www.jmedicalcasereports.com/content/2/1/36© 2008 Di Chiara et al; licensee BioMed Central Ltd.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0),which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Introduction: The incidence of anaphylactic reactions during anesthesia is between 1:5000 and 1:25000 and it is one of the few causes of mortality directly related to general anesthesia. The most important requirements in the treatment of this clinical condition are early diagnosis and maintenance of vital organ perfusion. Epinephrine administration is generally considered as the first line treatment of anaphylactic reactions. However, recently, new pharmacological approaches have been described in the treatment of different forms of vasoplegic shock. Case presentation: We describe the case of a child who was undergoing surgery for ventricular septal defect, with an anaphylactic reaction to heparin that was refractory to epinephrine infusion and was effectively treated by low dose vasopressin infusion. Conclusion: In case of anaphylactic shock, continuous infusion of low-dose vasopressin might be considered after inadequate response to epinephrine, fluid resuscitation and corticosteroid administration. describe a case in which low dose vasopressin promply re-IntroductionThe incidence of anaphylactic reactions during anesthesia established hemodynamic stability in a vasoplegic stateis between 1:5000 and 1:25000 and it is one of the few due to an anaphylactic reaction that was refractory tocauses of mortality directly related to general anesthesia epinephrine infusion.[1]. The most important requirements in the treatment ofthis clinical condition are early diagnosis and mainte- Case presentationnance of vital organ perfusion. Epinephrine administra- A 6-year-old 18 kg male with a ventricular septal defecttion is generally considered as the first line treatment of and history of asthma was scheduled for surgical correc-anaphylactic reactions [1]. However, recently, new phar- tion. The patient had never undergone general anesthesiamacological approaches have been described in the treat- and had a past medical history of bronchial asthmament of different forms of vasoplegic shock [2]. We treated with inhaled salbutamol. General anesthesia was Page 1 of 4 (page number not for citation purposes)Journal of Medical Case Reports 2008, 2:36 http://www.jmedicalcase ...