• Anesthesia and analgesia · Aug 2008

    Case Reports

    The pivotal role of vasopressin in refractory anaphylactic shock.

    • Claudia Schummer, Melanie Wirsing, and Wolfram Schummer.
    • Department for Anesthesiology and Intensive Care Medicine, SRH Zentralklinikum Suhl, Albert-Schweitzer str. 2, 98527 Suhl, Germany. cwsm.schummer@gmx.de
    • Anesth. Analg. 2008 Aug 1;107(2):620-4.

    BackgroundSevere anaphylaxis can be associated with cardiovascular collapse that is difficult to manage and does not respond to treatment with epinephrine. Because anaphylaxis is uncommon, unpredictable and may be fatal, a prospective, randomized, controlled trial in humans on the best management is difficult and guidelines are based on theory and anecdotes only.Methods And ResultsWe report six cases in which the use of vasopressin was successful in the treatment of anaphylactic shock.ConclusionsStandard treatment of anaphylactic shock, including discontinuation of the causative agent, administration of epinephrine, and infusion of IV fluids, did not stabilize cardiocirculatory function, and adding arginine vasopressors resulted in prompt hemodynamic stabilization.

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