Vasopressin and Anaphylactic Shock

http://www.medscape.com/viewarticle/571217

Role Of Vasopressin In The Treatment Of Anaphylactic Shock In A Child
Undergoing Surgery For Congenital Heart Disease: A Case Report
Posted 03/19/2008

Luca Di Chiara; Giulia V Stazi; Zaccaria Ricci; Angelo Polito; Stefano
Morelli; Chiara Giorni; Ondina La Salvia; Vincenzo Vitale; Eugenio
Rossi; Sergio Picardo

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Abstract and Introduction
Introduction: 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.
Case Presentation: 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.
Conclusion: In case of anaphylactic shock, continuous infusion of low-
dose vasopressin might be considered after inadequate response to
epinephrine, fluid resuscitation and corticosteroid administration.


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