Chlorhexidine related refractory anaphylactic shock: a case successfully resuscitated with extracorporeal membrane oxygenation.
IMPORTANCE We report a patient with a life threatening anaphylactic reaction to a chlorhexidine coated central venous catheter, confirmed with a high serum level of chlorhexidine specific IgE. To our knowledge, this is the first case successfully resuscitated using extracorporeal membrane oxygenation (ECMO) Great caution is required when using chlorhexidine and chlorhexidine impregnated catheters, given that its widespread use has the potential to sensitize certain patients and may result in life threatening anaphylaxis on subsequent exposure. OBSERVATIONS A case report of a single patient with life threatening anaphylactic shock to chlorhexidine, who was successfully resuscitated using ECMO. CONCLUSIONS We have designed a flowchart for the diagnosis and management of severe anaphylaxis. This case report highlights the potential for chlorhexidine to be a source for the development of refractory anaphylactic shock. We suggest that ECMO may save the lives of patients with severe bronchospasm and refractory anaphylactic shock secondary to chlorhexidine.
Journal of clinical anesthesia