Case Report Serious anaphylactic shock induced by hemocoagulase agkistrodon during anesthesia in a 5-year-old child
Yingyi Xu, Bilian Li, Yulin Jin, Zixin Johnson Wang, Xingrong Song, Jin Dong Ni
Abstract
Yingyi Xu, Bilian Li, Yulin Jin, Zixin Johnson Wang, Xingrong Song, Jin Dong Ni
Abstract
* Equal contributors. Received December 1, 2014; Accepted February 27, 2015; Epub March 15, 2015; Published March 30, 2015 Abstract: We report a case of serious anaphylactic shock in a 5-year-old child undergoing scheduled surgery blank space of a right femoral intramedullary nail removal. The boy had undergone right femoral elastic intramedullary nail fixation surgery 14 months prior, but had no history of allergies. Within 5 minutes of intravenous bonus injection of hemocoagulase agkistrodon (HCA) 1 unit, a widespread transient diffuse erythema was seen on the front of his chest. After 20 minutes, sudden, profound cardiovascular collapse occurred. The child was treated effectively and sent to a ward 5 hours later. In this period, he received intravenously infused 200 ml hydroxyethyl starch solution and epinephrine at a rate of 0.05-0.01 µg kg -1 min -1 . Total amount of dexamethasone sodium phosphate 14 mg was used. To the best of our knowledge, few case reports of HCA-induced anaphylactic shock in children exist. Our report will, therefore, increase awareness of the allergic potential of HCA among pediatric anesthesiologists.
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* Equal contributors. Received December 1, 2014; Accepted February 27, 2015; Epub March 15, 2015; Published March 30, 2015 Abstract: We report a case of serious anaphylactic shock in a 5-year-old child undergoing scheduled surgery blank space of a right femoral intramedullary nail removal. The boy had undergone right femoral elastic intramedullary nail fixation surgery 14 months prior, but had no history of allergies. Within 5 minutes of intravenous bonus injection of hemocoagulase agkistrodon (HCA) 1 unit, a widespread transient diffuse erythema was seen on the front of his chest. After 20 minutes, sudden, profound cardiovascular collapse occurred. The child was treated effectively and sent to a ward 5 hours later. In this period, he received intravenously infused 200 ml hydroxyethyl starch solution and epinephrine at a rate of 0.05-0.01 µg kg -1 min -1 . Total amount of dexamethasone sodium phosphate 14 mg was used. To the best of our knowledge, few case reports of HCA-induced anaphylactic shock in children exist. Our report will, therefore, increase awareness of the allergic potential of HCA among pediatric anesthesiologists.
Key concepts: Medicine, Hydroxyethyl starch, Anaphylactic shock, Erythema, Anesthesia, Surgery, Anaphylaxis, Intramedullary rod