Javaud N, Fain O, Bernot B, Adnet F, Lapostolle F
Samu-Smur 93, hôpital Avicenne, Assistance publique-Hôpitaux de Paris, université Paris-13, 125, rue de Stalingrad, 93000 Bobigny, France.
Ann Fr Anesth Reanim. 2011 Nov;30(11):848-50. doi: 10.1016/j.annfar.2011.07.005. Epub 2011 Oct 5.
We are reporting the case of a bradykinin-mediated angioedema, secondary to the angiotensin converting enzyme inhibitors, which delayed treatment could have unfavorably influence the vital prognostic of the patient. Initially, the patient had an isolated edema of the superior lip. Prehospital treatment included methylprednisolone, hydroxyzine and epinephrine. The patient was subsequently taken to the emergency department. His situation deteriorated. An edema of the cheeks and the tongue appeared. The transfer of the patient to an emergency department, specializing in kinin angioedema was organized, in order for the patient to receive specific treatments. After a subcutaneous injection of icatibant, the situation improved very rapidly, with a regression of the edema. This observation is consistent with the early use of the specific therapeutic in bradykinin-mediated angioedema. Any delay in administering the treatment can negatively impact the prognostic. The availability of such treatments should therefore be organized during the prehospital phase.
我们正在报告一例由缓激肽介导的血管性水肿病例,该病例继发于血管紧张素转换酶抑制剂,延迟治疗可能会对患者的重要预后产生不利影响。最初,患者仅出现上唇水肿。院前治疗包括甲泼尼龙、羟嗪和肾上腺素。患者随后被送往急诊科。他的病情恶化。脸颊和舌头出现水肿。为使患者接受特定治疗,安排将患者转至专门治疗激肽性血管性水肿的急诊科。皮下注射依卡替班后,情况迅速改善,水肿消退。该观察结果与缓激肽介导的血管性水肿早期使用特定治疗方法一致。治疗延迟会对预后产生负面影响。因此,应在院前阶段安排此类治疗方法的可用性。