May 21, 2005

Successful extracorporeal resuscitation of a probable perioperative anaphylactic shock due to atracurium

Annales Françaises D'anesthèsie Et De Rèanimation
E LafforgueC Saizy

Abstract

We report the case of a 55-year-old woman ASA 2 scheduled for a cholecystectomy, who presented 25 minutes after the induction, a circulatory arrest probably due to a cardiac anaphylaxis attributed to atracurium. After 60 minutes of futile resuscitation without any spontaneous cardiac rhythm a percutaneous cardiopulmonary bypass (CPB) was initiated. Twenty minutes later and after three external electric shocks electric cardiac activity returned normal. The weaning was possible 120 minutes later with catecholamine support. She left the intensive care unit on postoperative day seven after a laparotomy secondary to splenic injury due to intensive cardiopulmonary resuscitation. She was discharged home without any neurologic or cardiac sequellae. Biological assessment done during the circulatory arrest and cutaneous tests performed ten weeks later confirmed an isolated allergy to atracurium. CPB is the most efficient support in case of reversible cardiac arrest but unfortunately the less accessible outside from cardiac surgery unit.

  • References10
  • Citations5

Mentioned in this Paper

Disseminated Intravascular Coagulation
Anaphylaxis (Non Medication)
Catecholamine [EPC]
Spleen
Discipline of Heart Surgery
Salix - substance
Basic Cardiac Life Support
Shock
Cardiac Rhythm Type
Injuries, Surgical

Related Feeds

Anaphylaxis

Anaphylaxis is a serious allergic reaction that is rapid in onset and may cause death.