Successful treatment of severe anaphylactic shock with vasopressin: Two case reports
Severe anaphylactic shock is a life-threatening situation that needs immediate treatment of progressive hemodynamic failure. We report two cases of severe anaphylactic shock treated with arginine-vasopressin (AVP): In a 42-year-old male patient anaphylactic shock was caused by the sting of a hornet....
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| Veröffentlicht in: | International archives of allergy and immunology 2004-07, Vol.134 (3), p.260-261 |
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| container_title | International archives of allergy and immunology |
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| creator | KILL, Clemens WRANZE, Erich WULF, Hinnerk |
| description | Severe anaphylactic shock is a life-threatening situation that needs immediate treatment of progressive hemodynamic failure. We report two cases of severe anaphylactic shock treated with arginine-vasopressin (AVP): In a 42-year-old male patient anaphylactic shock was caused by the sting of a hornet. At the scene, he was found unconscious, cyanotic, with a heart rate of 130/min without measurable blood pressure. The patient was intubated and ventilated with 100% oxygen, intravenous epinephrine (1 mg over 2 min) had no effect on blood pressure. After injection of 10 IU vasopressin, followed by infusion of 40 IU vasopressin, hemodynamics could be stabilized at once. In the second case, a 47-year-old male patient was stung by a wasp. At the scene he was unconscious, blood pressure was not measurable, heart rate was 140/min. The patient was treated with 40 IU vasopressin followed by rapid infusion of 500 ml NaCl 0.9%. After injection of vasopressin, blood pressure raised to 80/50 mm Hg and heart rate decreased to 90/min. Both patients needed ventilator therapy for several days and recovered fully. |
| doi_str_mv | 10.1159/000078775 |
| format | Article |
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We report two cases of severe anaphylactic shock treated with arginine-vasopressin (AVP): In a 42-year-old male patient anaphylactic shock was caused by the sting of a hornet. At the scene, he was found unconscious, cyanotic, with a heart rate of 130/min without measurable blood pressure. The patient was intubated and ventilated with 100% oxygen, intravenous epinephrine (1 mg over 2 min) had no effect on blood pressure. After injection of 10 IU vasopressin, followed by infusion of 40 IU vasopressin, hemodynamics could be stabilized at once. In the second case, a 47-year-old male patient was stung by a wasp. At the scene he was unconscious, blood pressure was not measurable, heart rate was 140/min. The patient was treated with 40 IU vasopressin followed by rapid infusion of 500 ml NaCl 0.9%. After injection of vasopressin, blood pressure raised to 80/50 mm Hg and heart rate decreased to 90/min. Both patients needed ventilator therapy for several days and recovered fully.</description><identifier>ISSN: 1018-2438</identifier><identifier>EISSN: 1423-0097</identifier><identifier>DOI: 10.1159/000078775</identifier><identifier>PMID: 15178897</identifier><language>eng</language><publisher>Basel: Karger</publisher><subject>Adult ; Allergies ; Anaphylaxis - drug therapy ; Anaphylaxis - etiology ; Animals ; Arginine Vasopressin - therapeutic use ; Biological and medical sciences ; Case studies ; Fundamental and applied biological sciences. Psychology ; Fundamental immunology ; Hormones ; Humans ; Immunopathology ; Insect bites ; Insect Bites and Stings - complications ; Male ; Medical diagnosis ; Medical sciences ; Medical treatment ; Middle Aged ; Vasoconstrictor Agents - therapeutic use ; Wasps</subject><ispartof>International archives of allergy and immunology, 2004-07, Vol.134 (3), p.260-261</ispartof><rights>2004 INIST-CNRS</rights><rights>Copyright 2004 S. 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We report two cases of severe anaphylactic shock treated with arginine-vasopressin (AVP): In a 42-year-old male patient anaphylactic shock was caused by the sting of a hornet. At the scene, he was found unconscious, cyanotic, with a heart rate of 130/min without measurable blood pressure. The patient was intubated and ventilated with 100% oxygen, intravenous epinephrine (1 mg over 2 min) had no effect on blood pressure. After injection of 10 IU vasopressin, followed by infusion of 40 IU vasopressin, hemodynamics could be stabilized at once. In the second case, a 47-year-old male patient was stung by a wasp. At the scene he was unconscious, blood pressure was not measurable, heart rate was 140/min. The patient was treated with 40 IU vasopressin followed by rapid infusion of 500 ml NaCl 0.9%. After injection of vasopressin, blood pressure raised to 80/50 mm Hg and heart rate decreased to 90/min. Both patients needed ventilator therapy for several days and recovered fully.</description><subject>Adult</subject><subject>Allergies</subject><subject>Anaphylaxis - drug therapy</subject><subject>Anaphylaxis - etiology</subject><subject>Animals</subject><subject>Arginine Vasopressin - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Case studies</subject><subject>Fundamental and applied biological sciences. 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We report two cases of severe anaphylactic shock treated with arginine-vasopressin (AVP): In a 42-year-old male patient anaphylactic shock was caused by the sting of a hornet. At the scene, he was found unconscious, cyanotic, with a heart rate of 130/min without measurable blood pressure. The patient was intubated and ventilated with 100% oxygen, intravenous epinephrine (1 mg over 2 min) had no effect on blood pressure. After injection of 10 IU vasopressin, followed by infusion of 40 IU vasopressin, hemodynamics could be stabilized at once. In the second case, a 47-year-old male patient was stung by a wasp. At the scene he was unconscious, blood pressure was not measurable, heart rate was 140/min. The patient was treated with 40 IU vasopressin followed by rapid infusion of 500 ml NaCl 0.9%. After injection of vasopressin, blood pressure raised to 80/50 mm Hg and heart rate decreased to 90/min. 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| subjects | Adult Allergies Anaphylaxis - drug therapy Anaphylaxis - etiology Animals Arginine Vasopressin - therapeutic use Biological and medical sciences Case studies Fundamental and applied biological sciences. Psychology Fundamental immunology Hormones Humans Immunopathology Insect bites Insect Bites and Stings - complications Male Medical diagnosis Medical sciences Medical treatment Middle Aged Vasoconstrictor Agents - therapeutic use Wasps |
| title | Successful treatment of severe anaphylactic shock with vasopressin: Two case reports |
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