Successful rescue of a patient with anaphylactic shock under general anesthesia possibly induced by Ceftriaxone Sodium
ZHOU Qingyun CUI Yin GU Xiaoping
Department of Anesthesiology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Jiangsu Province, Nanjing 210008, China
Abstract Anaphylactic shock is not only one of the common clinical emergencies, but also the focus and difficulty of clinical work, which accounts for an important proportion in medical disputes. Anaphylactic shock often occurs suddenly and violently. If it is not treated in time, the patient may die rapidly due to serious cardiovascular and respiratory dysfunction. There are many allergens that lead to anaphylactic shock, mainly including antibiotics, antitumor drugs, contrast agents, and anesthetics, among which antibiotics account for an important part. This study reported the anesthesia and rescue process of a patient with suspected anaphylactic shock caused by ceftriaxone sodium. The allergens, guidelines, and rescue measures of anaphylactic shock were discussed and analyzed in order to improve the clinicians’ understanding of the disease.
ZHOU Qingyun CUI Yin GU Xiaoping. Successful rescue of a patient with anaphylactic shock under general anesthesia possibly induced by Ceftriaxone Sodium[J]. 中国医药导报, 2022, 19(24): 179-182.
[1] 林辉龙.药源性过敏性休克死亡98例分析[J].中国医院药学杂志，2006，26（3）：365-367.
[2] 曹楠，黄飞骏.药物过敏性休克死亡法医学分析21例[J].中国法医学杂志，2013，28（1）：72-73，89.
[3] 宗雨，胡利国.围手术期过敏反应[J].国际麻醉学与复苏杂志，2018，39（10）：982-986.
[4] 胡利国，柴小青，梅斌，等.围麻醉期严重过敏反应的多中心回顾性分析[J].临床麻醉学杂志，2017，33（1）：74-76.
[5] 王博杰，郭超，李春晶，等.围麻醉期过敏反应发生率及危险因素分析：一项2012-2017年回顾性调查[J].北京大学学报，2018，50（1）：193-199.
[6] Kelkar PS，Li JT. Cephalosporin allergy [J]. N Engl J Med，2001，345（11）：804-809.
[7] Riezzo I，Bello S，Neri M，et al. Ceftriaxone intradermal test-related fatal anaphylactic shock：a medico-legal nightmare [J]. Allergy，2010，65（1）：130-131.
[8] Prashant K，Girdhar K，Raktima A，et al. Life Claiming Anaphylaxis to Intravenous Ceftriaxone after Negative Skin Test [J]. Indian Anaesthetists Forum，2005，6（4）.
[9] Khan DA，Banerji A，Bernstein JA，et al. Cephalosporin Allergy：Current Understanding and Future Challenges [J]. J Allergy Clin Immunol Pract，2019，7（7）：2105-2114.
[10] Yang MS，Kang DY，Seo B，et al. Incidence of cephalosporin-induced anaphylaxis and clinical efficacy of screening intradermal tests with cephalosporins：A large multicenter retrospective cohort study [J]. Allergy，2018，73（9）：1833-1841.
[11] Shrestha D，Dhakal AK，Shakya H，et al. A report of near fatal ceftriaxone induced anaphylaxis in a child with review of literature [J]. Nepal Med Coll J，2013，15（1）：84-86.
[12] Kolawole H，Marshall SD，Crilly H，et al. Australian and New Zealand Anaesthetic Allergy Group/Australian and New Zealand College of Anaesthetists Perioperative Anaphylaxis Management Guidelines [J]. Anaesth Intensive Care，2017，45（2）：151-158.
[13] Panchal AR，Berg KM，Hirsch KG，et al. 2019 American Heart Association Focused Update on Advanced Cardiovascular Life Support：Use of Advanced Airways，Vasopressors，and Extracorporeal Cardiopulmonary Resuscitation During Cardiac Arrest：An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care [J]. Circulation，2019，140（24）：e881-e894.
[14] Harper N，Cook TM，Garcez T，et al. Anaesthesia，surgery，and life-threatening allergic reactions：epidemiology and clinical features of perioperative anaphylaxis in the 6th National Audit Project （NAP6） [J]. Br J Anaesth，2018， 121（1）：159-171.
[15] Harper N，Nolan JP，Soar J，et al. Why chest compressions should start when systolic arterial blood pressure is below 50 mm Hg in the anaesthetised patient [J]. Br J Anaesth，2020，124（3）：234-238.
[16] Garvey LH，Dewachter P，Hepner DL，et al. Management of suspected immediate perioperative allergic reactions：an international overview and consensus recommendations [J]. Br J Anaesth，2019，123（1）：e50-e64.
[17] Nolan JP，Berg RA，Andersen LW，et al. Cardiac Arrest and Cardiopulmonary Resuscitation Outcome Reports：Update of the Utstein Resuscitation Registry Template for In-Hospital Cardiac Arrest：A Consensus Report From a Task Force of the International Liaison Committee on Resuscitation （American Heart Association，European Resuscitation Council，Australian and New Zealand Council on Resuscitation，Heart and Stroke Foundation of Canada，InterAmerican Heart Foundation，Resuscitation Council of Southern Africa，Resuscitation Council of Asia） [J]. Resuscitation，2019，144：166-177.
[18] Wesselink EM，Kappen TH，Torn HM，et al. Intraoperative hypotension and the risk of postoperative adverse outcomes：a systematic review [J]. Br J Anaesth，2018， 121（4）：706-721.
[19] Soar J，Nolan JP，Bttiger BW，et al. European Resuscitation Council Guidelines for Resuscitation 2015：Section 3. Adult advanced life support [J]. Resuscitation，2015， 95：100-147.
[20] 曾雪萍，孙峰，徐军.呼气末二氧化碳分压在血流动力学管理中的应用进展[J].中国急救医学，2019，39（2）：192-195.
[21] 杜兰芳，马青变.《2020年中国心脏骤停后脑保护专家共识》解读二：目标温度管理[J].中华脑血管病杂志，2021，15（5）：293-296.
[22] 郑康，杜兰芳，李姝，等.北京大学第三医院心脏骤停后目标温度管理实施规范[J].中国急救医学，2021，41（7）：588-592.
[23] 荀静，祁静，周梦良，等.颅脑创伤患者目标温度管理护理实践最佳证据总结[J].解放军护理杂志，2021，38（4）：70-73，88.
[24] 谈定玉，付阳阳，徐军，等.心肺复苏中通气的研究进展[J].中华危重病急救医学，2016，28（7）：661-665.
[25] 文才，余涛，王立祥.心肺复苏过程中机械通气策略研究进展[J].中华危重病急救医学，2017，29（9）：853-856.
