Use of IABP in contrast media-induced anaphylactic shock: the ultimate lifesaver

Abstract

SUMMARYAnaphylactic reaction to contrast media during selective coronary angiography is a rare occurrence. It can be occasionally resistant to medical treatment leading to cardiovascular collapse and death. The use of intra-aortic balloon pump (IABP) counter-pulsation when the supportive medical treatment fails during anaphylactic shock is not well documented in the literature. We report a case of a severe contrast media-induced anaphylactic shock which failed to respond to the supportive medical management and the timely insertion of IABP for further circulatory support that prevented death in a patient who had an elective diagnostic coronary angiography. The clinical diagnosis of anaphylaxis was challenging at the onset of shock as the typical rash developed after a few minutes. BACKGROUND

Clinical characteristics and management of iodine contrast media-related anaphylactic shock during cardiac catheterization

“…Alam et al reported a case of ICM-related AS that was unresponsive to the conventional medical therapy, but insertion of an IABP prevented death. 22 Another similar case report by Sugiura and colleague described the combined use of extracorporeal membrane oxygenation and hemodialysis and IABP to treat contrast-mediated anaphylaxis. 23 However, according to our data, the concomitant diseases, cardiac function, and renal function were similar at baseline between the groups.…”

Analysis of Anaphylaxis and Anaphylaxis-Like Reactions-A Qualitative Study

“…It is also difficult because it occurs in the presence of multiple drugs. In some patients, onset of anaphylaxis may happen after considerable lag period leading to diagnostic delay or missing the diagnosis [5]. In some patients, when the predominant symptoms of anaphylaxis are gastrointestinal, anaphylaxis may not at all be recognized [6].…”