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Vasopressin for the management of catecholamine-resistant anaphylactic shock.
Singapore Med J 2008; 49(9):e225-8SM

Abstract

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+Show Affiliations

Department of Anesthesiology, Aga Khan University Hospital, Stadium Road, PO Box 3500, Karachi 74800, Pakistan. aziza.mohammad@aku.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

18830525

Citation

Hussain, A M., et al. "Vasopressin for the Management of Catecholamine-resistant Anaphylactic Shock." Singapore Medical Journal, vol. 49, no. 9, 2008, pp. e225-8.
Hussain AM, Yousuf B, Khan MA, et al. Vasopressin for the management of catecholamine-resistant anaphylactic shock. Singapore Med J. 2008;49(9):e225-8.
Hussain, A. M., Yousuf, B., Khan, M. A., Khan, F. H., & Khan, F. A. (2008). Vasopressin for the management of catecholamine-resistant anaphylactic shock. Singapore Medical Journal, 49(9), pp. e225-8.
Hussain AM, et al. Vasopressin for the Management of Catecholamine-resistant Anaphylactic Shock. Singapore Med J. 2008;49(9):e225-8. PubMed PMID: 18830525.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vasopressin for the management of catecholamine-resistant anaphylactic shock. AU - Hussain,A M, AU - Yousuf,B, AU - Khan,M A, AU - Khan,F H, AU - Khan,F A, PY - 2008/10/3/pubmed PY - 2009/7/16/medline PY - 2008/10/3/entrez SP - e225 EP - 8 JF - Singapore medical journal JO - Singapore Med J VL - 49 IS - 9 N2 - 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. SN - 0037-5675 UR - https://www.unboundmedicine.com/medline/citation/18830525/Vasopressin_for_the_management_of_catecholamine_resistant_anaphylactic_shock_ L2 - http://smj.sma.org.sg/4909/4909cr3.pdf DB - PRIME DP - Unbound Medicine ER -