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Successful treatment of severe anaphylactic shock with vasopressin. Two case reports.

Abstract

Severe anaphylactic shock is a life-threatening situation that needs immediate treatment of progressive hemodynamic failure. We report two cases of severe anaphylactic shock treated with arginine-vasopressin (AVP): In a 42-year-old male patient anaphylactic shock was caused by the sting of a hornet. At the scene, he was found unconscious, cyanotic, with a heart rate of 130/min without measurable blood pressure. The patient was intubated and ventilated with 100% oxygen, intravenous epinephrine (1 mg over 2 min) had no effect on blood pressure. After injection of 10 IU vasopressin, followed by infusion of 40 IU vasopressin, hemodynamics could be stabilized at once. In the second case, a 47-year-old male patient was stung by a wasp. At the scene he was unconscious, blood pressure was not measurable, heart rate was 140/min. The patient was treated with 40 IU vasopressin followed by rapid infusion of 500 ml NaCl 0.9%. After injection of vasopressin, blood pressure raised to 80/50 mm Hg and heart rate decreased to 90/min. Both patients needed ventilator therapy for several days and recovered fully.

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  • Authors+Show Affiliations

    ,

    Department of Anaesthesiology and Critical Care, Philipps University, Marburg, Germany. killc@mailer.uni-marburg.de

    ,

    Source

    MeSH

    Adult
    Anaphylaxis
    Animals
    Arginine Vasopressin
    Humans
    Insect Bites and Stings
    Male
    Middle Aged
    Vasoconstrictor Agents
    Wasps

    Pub Type(s)

    Case Reports
    Journal Article

    Language

    eng

    PubMed ID

    15178897

    Citation

    Kill, Clemens, et al. "Successful Treatment of Severe Anaphylactic Shock With Vasopressin. Two Case Reports." International Archives of Allergy and Immunology, vol. 134, no. 3, 2004, pp. 260-1.
    Kill C, Wranze E, Wulf H. Successful treatment of severe anaphylactic shock with vasopressin. Two case reports. Int Arch Allergy Immunol. 2004;134(3):260-1.
    Kill, C., Wranze, E., & Wulf, H. (2004). Successful treatment of severe anaphylactic shock with vasopressin. Two case reports. International Archives of Allergy and Immunology, 134(3), pp. 260-1.
    Kill C, Wranze E, Wulf H. Successful Treatment of Severe Anaphylactic Shock With Vasopressin. Two Case Reports. Int Arch Allergy Immunol. 2004;134(3):260-1. PubMed PMID: 15178897.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Successful treatment of severe anaphylactic shock with vasopressin. Two case reports. AU - Kill,Clemens, AU - Wranze,Erich, AU - Wulf,Hinnerk, Y1 - 2004/06/01/ PY - 2003/12/04/received PY - 2004/01/29/accepted PY - 2004/6/5/pubmed PY - 2004/8/3/medline PY - 2004/6/5/entrez SP - 260 EP - 1 JF - International archives of allergy and immunology JO - Int. Arch. Allergy Immunol. VL - 134 IS - 3 N2 - Severe anaphylactic shock is a life-threatening situation that needs immediate treatment of progressive hemodynamic failure. We report two cases of severe anaphylactic shock treated with arginine-vasopressin (AVP): In a 42-year-old male patient anaphylactic shock was caused by the sting of a hornet. At the scene, he was found unconscious, cyanotic, with a heart rate of 130/min without measurable blood pressure. The patient was intubated and ventilated with 100% oxygen, intravenous epinephrine (1 mg over 2 min) had no effect on blood pressure. After injection of 10 IU vasopressin, followed by infusion of 40 IU vasopressin, hemodynamics could be stabilized at once. In the second case, a 47-year-old male patient was stung by a wasp. At the scene he was unconscious, blood pressure was not measurable, heart rate was 140/min. The patient was treated with 40 IU vasopressin followed by rapid infusion of 500 ml NaCl 0.9%. After injection of vasopressin, blood pressure raised to 80/50 mm Hg and heart rate decreased to 90/min. Both patients needed ventilator therapy for several days and recovered fully. SN - 1018-2438 UR - https://www.unboundmedicine.com/medline/citation/15178897/full_citation L2 - https://www.karger.com?DOI=10.1159/000078775 DB - PRIME DP - Unbound Medicine ER -