Research Information System
22nd of International Intensive Care Symposium, İstanbul, Turkey, 3 - 04 May 2019, (Summary Text)
INTRODUCTION Anaphylaxis is a severe allergic reactionthat can be fatal at the time of contact with allergen substances. We discussed the developing case of anaphylactic reaction who applied CVVHDF with copolymerized polyacrylonitrile (AN69) dialyser an unconscious patient. CASE A 63-year-old male patient was accepted to the ICU with the diagnosis of cardiopulmonary arrest. After hospitalization developing renal failure in patients with CVVHDF treatment was started. During the procedure, dyspnoea, tachypnea (32 / min) developed, N: 135 / min, TA: 50/40 mmhg measure in the patient. An infusion of adrenaline was started and procedure was terminated.2 days later, CVVHDF was started for the second time. Due to the development of dyspnoea, tachypnea, andhypotension in the 10th minute of procedure considering membrane anaphylaxis, treatment terminated. Hypotensive patient was started treatment with adrenaline infusion, antihistaminic and steroid. In 24 hours, the hemodynamic parameters were improved and the vasopressor support was terminated. DISCUSSION In the anaphylactic reaction, it is important to solve the hypotension and respiratory tract problems resolves of top priority and to provide advanced airway support if necessary. The first and most important step in the treatment is to administer epinephrine rapidly and fill the vascular bed and give intravenous (iv) fluid treatment to increase circulation. Second line therapy includes corticosteroids and antihistamines. PAN membrane AN69 dialyser with CVVHDF administer, anaphylaxis was developed in the clinical worsening patient. The case was finishing by completion of treatment, by applied of steroid, antihistamine, and norepinephrine. CONCLUSION Even if just a rarely cause an anaphylactic reaction it should be kept in mind that the used AN69 and the methallylsulfonate during in continuous renal replacement therapy. In patients with unconsciousness, anaphylactic reaction due to membrane should be considered in the pre-diagnosis when during process suddenly hypotension, dyspnoea and tachypnea findings develop.