Di Chiara Luca, Stazi Giulia V, Ricci Zaccaria, Polito Angelo, Morelli Stefano, Giorni Chiara, La Salvia Ondina, Vitale Vincenzo, Rossi Eugenio, Picardo Sergio
Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Hospital, Rome, Italy.
J Med Case Rep. 2008 Feb 5;2:36. doi: 10.1186/1752-1947-2-36.
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.
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.
In case of anaphylactic shock, continuous infusion of low-dose vasopressin might be considered after inadequate response to epinephrine, fluid resuscitation and corticosteroid administration.
麻醉期间过敏反应的发生率在1:5000至1:25000之间，是直接与全身麻醉相关的少数死亡原因之一。治疗这种临床病症的最重要要求是早期诊断和维持重要器官灌注。肾上腺素给药通常被视为过敏反应的一线治疗方法。然而，最近在不同形式的血管麻痹性休克治疗中描述了新的药理学方法。
我们描述了一名正在接受室间隔缺损手术的儿童病例，该儿童对肝素发生过敏反应，对肾上腺素输注无效，经低剂量血管加压素输注有效治疗。
在过敏性休克的情况下，如果对肾上腺素、液体复苏和皮质类固醇给药反应不足，可考虑持续输注低剂量血管加压素。
