Literature DB >> 33665061

Intraoperative Hypotension in a Patient with Antithrombin Deficiency, Bilateral Pulmonary Emboli, and Cefazolin Allergy.

Aaron R Muncey1, Nasrin N Aldawoodi2, Ahish Chitneni3, Jamie P Hoffman2, Allan R Escher4.   

Abstract

In medicine, the search for a clear answer can at times be elusive. However, this does not necessarily preclude the administration of intelligent and thoughtful therapeutic treatments. Here, we describe a complicated emergent event of severe hypotension and near-arrest that occurred in the operating room in a young, healthy woman undergoing outpatient thyroid surgery. We detail the situation as it presented in the operating room and the measures taken to rule out potential life-threatening diagnoses and develop a thoughtful treatment plan. We further describe the evidence for and against the two remaining diagnostic possibilities: anaphylaxis versus acute pulmonary embolism.
Copyright © 2021, Muncey et al.

Entities:  

Keywords:  allergy and anaphylaxis; antithrombin deficiency; antithrombin iii; follicular neoplasm; hypercoagulable state; mottling; pulmonary emboli; stanford emergency manual; thyroid neoplasm; tryptase

Year:  2021        PMID: 33665061      PMCID: PMC7924311          DOI: 10.7759/cureus.13653

Source DB:  PubMed          Journal:  Cureus        ISSN: 2168-8184


  12 in total

1.  Perioperative anaphylaxis.

Authors:  P M Mertes; M Lambert; R M Guéant-Rodriguez; I Aimone-Gastin; C Mouton-Faivre; D A Moneret-Vautrin; J L Guéant; J M Malinovsky; P Demoly
Journal:  Immunol Allergy Clin North Am       Date:  2009-08       Impact factor: 3.479

2.  Identification and Management of Perioperative Anaphylaxis.

Authors:  Gerald W Volcheck; David L Hepner
Journal:  J Allergy Clin Immunol Pract       Date:  2019-05-31

Review 3.  Management of antithrombin deficiency: an update for clinicians.

Authors:  Carlos Bravo-Pérez; Vicente Vicente; Javier Corral
Journal:  Expert Rev Hematol       Date:  2019-05-22       Impact factor: 2.929

Review 4.  Epinephrine and its use in anaphylaxis: current issues.

Authors:  Keith J Simons; F Estelle R Simons
Journal:  Curr Opin Allergy Clin Immunol       Date:  2010-08

Review 5.  Inherited antithrombin deficiency: a review.

Authors:  M M Patnaik; S Moll
Journal:  Haemophilia       Date:  2008-11       Impact factor: 4.287

Review 6.  Epidemiology of perioperative anaphylaxis.

Authors:  Paul Michel Mertes; Gerald W Volcheck; Lene H Garvey; Tonomori Takazawa; Peter R Platt; Anne B Guttormsen; Charles Tacquard
Journal:  Presse Med       Date:  2016-05-12       Impact factor: 1.228

Review 7.  Acute pulmonary embolism. Aggressive therapy with anticoagulants and thrombolytics.

Authors:  J A Handler; C F Feied
Journal:  Postgrad Med       Date:  1995-01       Impact factor: 3.840

Review 8.  Practical Guidelines for Perioperative Hypersensitivity Reactions.

Authors:  J J Laguna; J Archilla; I Doña; M Corominas; G Gastaminza; C Mayorga; P Berjes-Gimeno; P Tornero; S Martin; A Planas; E Moreno; M J Torres
Journal:  J Investig Allergol Clin Immunol       Date:  2018-02-07       Impact factor: 4.333

9.  Multi-centre retrospective analysis of anaphylaxis during general anaesthesia in the United Kingdom: aetiology and diagnostic performance of acute serum tryptase.

Authors:  M T Krishna; M York; T Chin; G Gnanakumaran; J Heslegrave; C Derbridge; A Huissoon; L Diwakar; E Eren; R J Crossman; N Khan; A P Williams
Journal:  Clin Exp Immunol       Date:  2014-11       Impact factor: 4.330

Review 10.  The serum tryptase test: an emerging robust biomarker in clinical hematology.

Authors:  Peter Valent; Wolfgang R Sperr; Karl Sotlar; Andreas Reiter; Cem Akin; Jason Gotlib; Hans-Peter Horny; Michel Arock
Journal:  Expert Rev Hematol       Date:  2014-08-28       Impact factor: 2.929

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