Anaphylactic shock and cardiac arrest induced by iobitridol injection

A 74-year-old man with old fracture of right femoral neck was planned to undergo CT angiography to determine whether there were both lower extremities arteriosclerosis occlusion. The patient was negative for iodine anaphylactic test. About one minute after an IV injection of iobitridol start, the patient suddenly experienced loss of consciousness, asphygmia, and undetectable blood pressure. Iobitridol was stopped immediately and he was given oxygen inhalation and cardiopulmonary resuscitation immediately. Five minutes later, his heart rate was 121 beats per minute and blood pressure was 86/47 mm Hg. An intravenous injection of dexamethasone 10 mg and epinephrine 3 mg were administered. Twenty-three minutes later, his heart rate was 119 beats per minute and blood pressure was 205/140 mm Hg. Agitation appeared in the patient. Twenty-nine minutes later, his heart rate was 99 beats per minute and the electrocardiogram showed sinus rhythm. The patient was continuously treated with anti-infection, improvement of cardiac function, and alleviation of pulmonary edema. Seven days later, the patient's condition was stable. Key words: Drug hypersensitivity; Heart arrest; Iobitridol