Abstract
An otherwise straightforward three-vessel coronary bypass procedure to be performed as your second case of the day of arrests on induction shortly after administration of preoperative antibiotic prophylaxis and suddenly experiences hemodynamic collapse. While you are considering opening the chest emergently the anesthesiologist recognizes that the patient had a documented allergy with anaphylaxis to beta-lactam medications that had somehow been missed in the preoperative briefing. The patient's hypotension, urticaria, wheezing and bronchospasm indicate anaphylaxis. The patient is resuscitated with volume, epinephrine, antihistamines and corticosteroids as well as inhaled beta-2 agonists. With a serum tryptase level sent to the lab. The case is canceled, and the patient supported in the ICU overnight to allow for recovery from this near miss.
| Original language | English |
|---|---|
| Title of host publication | Near Misses in Cardiac Surgery |
| Publisher | Springer |
| Pages | 59-62 |
| Number of pages | 4 |
| ISBN (Electronic) | 9783030927509 |
| ISBN (Print) | 9783030927493 |
| DOIs | |
| State | Published - 1 Mar 2022 |
| Externally published | Yes |
Keywords
- Anaphylaxis
- Anesthetic induction
- Cardiopulmonary resuscitation
- Coronary artery bypass grafting
- Left main coronary artery disease