Chlorhexidine Impregnated Central Venous Catheter Inducing an Anaphylatic Shock in the Intensive Care Unit

Khoo, Anthony; Oziemski, Peter

doi:10.1016/j.hlc.2010.10.001

Cited by 21 publications

(12 citation statements)

References 6 publications

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“…The widespread and often undocumented use of this agent means that it is frequently unrecognised as a possible cause of allergic reactions 58,59 . If the patient is exposed to chlorhexidine intravenously, such as with chlorhexidine impregnated central venous access devices, anaphylaxis is likely to develop rapidly 60 . If chlorhexidine is absorbed across mucous membranes anaphylaxis is often delayed, as may occur with chlorhexidine containing urethral gels.…”

Section: Chlorhexidinementioning

confidence: 99%

Australian and New Zealand Anaesthetic Allergy Group Perioperative Anaphylaxis Investigation Guidelines

Scolaro

Crilly

Maycock

et al. 2017

Anaesth Intensive Care

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These guidelines are a consensus document developed by a working party of the Australian and New Zealand Anaesthetic Allergy Group (ANZAAG) to provide an approach to the investigation of perioperative anaphylaxis. They focus primarily on the use of skin testing as it is the investigation with the greatest clinical utility for the identification of the likely causative agent and potentially safer alternatives. The practicalities and process of skin testing, its limitations, and the place of other tests are discussed. These guidelines also address the roles of graded challenge and in vitro testing. The implications of anaphylaxis associated with neuromuscular blocking agents, beta-lactam antibiotics, local anaesthetic agents and chlorhexidine are discussed. Evidence for the recommendations is derived from literature searches using the words skin test, allergy, anaphylaxis, anaesthesia, and each of the individual agents listed in these guidelines. The individual articles were then reviewed for suitability for inclusion in these guidelines. Where evidence was not strong, as is the situation for many perioperative agents, expert consensus from the ANZAAG working party was used. These guidelines are intended for use by specialists involved in the investigation of perioperative allergy. They have been approved following peer review by members of ANZAAG and are available on the ANZAAG website: http://www.anzaag.com/anaphylaxis-management/testing-guidelines.pdf.

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Section: Chlorhexidinementioning

confidence: 99%

Australian and New Zealand Anaesthetic Allergy Group Perioperative Anaphylaxis Investigation Guidelines

Scolaro

Crilly

Maycock

et al. 2017

Anaesth Intensive Care

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“…The first CHL‐containing gel anaphylaxis was described in 1992 and the first CHL‐impregnated CVC anaphylaxis was reported in 1997 . The true incidence is unknown but likely under‐reported . Several authors suggest it is ‘rare’ but numerous studies indicate otherwise with incidence ranging from 5.5% to 8.8% .…”

Section: Discussionmentioning

confidence: 99%

“…Explanations include being unaware of the product containing CHL and not testing patients for CHL allergy after their initial anaphylaxis . Many clinicians wrongly attributed their patient's anaphylaxis to another agent such as latex, anaesthetic drugs, penicillin and cefazolin . However, in all the aforementioned, a second anaphylactic reaction occurred prompting appropriate investigation where CHL‐induced anaphylaxis was diagnosed.…”

Section: Discussionmentioning

confidence: 99%

Chlorhexidine‐induced anaphylaxis in surgical patients: a review of the literature

Sharp

Green

Rose

2015

ANZ Journal of Surgery

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In order to reduce abandoned procedures, unplanned intensive care unit admissions, morbidity and mortality associated with CHL-induced anaphylaxis we recommend the following: rationalization of CHL-containing products, greater vigilance regarding subtle symptoms of CHL allergy, appropriate investigation of these symptoms and a greater awareness of CHL-containing products. Lastly, we outline the appropriate investigations and highlight the need for meticulous documentation in those who are CHL allergic.

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“…83,[100][101][102][104][105][106][107][108][109][110][112][113][114][115][116][117]119,120 Cases of anaphylactic shock are reported after placement of a catheter coated with chlorhexidine and silver sulfadiazine (Category B4-H evidence). [121][122][123][124][125][126][127][128][129] Survey Findings. The consultants and ASA members agree with the recommendation to use catheters coated with antibiotics or a combination of chlorhexidine and silver sulfadiazine based on infectious risk and anticipated duration of catheter use for selected patients.…”

Section: Practice Guidelines For Central Venous Accessmentioning

confidence: 99%

Practice Guidelines for Central Venous Access 2020

2020

Anesthesiology

139

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These practice guidelines update the Practice Guidelines for Central Venous Access: A Report by the American Society of Anesthesiologists Task Force on Central Venous Access, adopted by the American Society of Anesthesiologists in 2011 and published in 2012. These updated guidelines are intended for use by anesthesiologists and individuals under the supervision of an anesthesiologist and may also serve as a resource for other physicians, nurses, or healthcare providers who manage patients with central venous catheters. Supplemental Digital Content is available in the text.

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Chlorhexidine Impregnated Central Venous Catheter Inducing an Anaphylatic Shock in the Intensive Care Unit

Cited by 21 publications

References 6 publications

Australian and New Zealand Anaesthetic Allergy Group Perioperative Anaphylaxis Investigation Guidelines

Australian and New Zealand Anaesthetic Allergy Group Perioperative Anaphylaxis Investigation Guidelines

Chlorhexidine‐induced anaphylaxis in surgical patients: a review of the literature

Practice Guidelines for Central Venous Access 2020

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