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Cardiac Arrest Due to Perioperative Anaphylactic Shock Induced by Re-Exposure to Propofol: A Case Report.

J Clin Med

September 2024

Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.

Article Synopsis
  • - Anaphylaxis is a serious allergic reaction that can be life-threatening and is especially difficult to diagnose during anesthesia due to the complex medical environment.
  • - A case study presented a patient who experienced propofol-induced anaphylactic shock after multiple safe exposures to the same anesthetic agents, leading to a cardiac arrest without typical symptoms of anaphylaxis.
  • - The diagnosis was confirmed through elevated serum tryptase levels and skin tests, emphasizing the need for awareness of severe allergic reactions even after previous safe use of medications, as sensitization can cause unexpected and serious outcomes.
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Evaluation of the classifications of severity in acute respiratory distress syndrome in childhood by the Berlin Consensus and the Pediatric Acute Lung Injury Consensus Conference.

Crit Care Sci

June 2024

Postgraduate Program in Maternal and Child Health, Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro - Rio de Janeiro (RJ), Brazil.

Objective: To compare two methods for defining and classifying the severity of pediatric acute respiratory distress syndrome: the Berlin classification, which uses the relationship between the partial pressure of oxygen and the fraction of inspired oxygen, and the classification of the Pediatric Acute Lung Injury Consensus Conference, which uses the oxygenation index.

Methods: This was a prospective study of patients aged 0 - 18 years with a diagnosis of acute respiratory distress syndrome who were invasively mechanically ventilated and provided one to three arterial blood gas samples, totaling 140 valid measurements. These measures were evaluated for correlation using the Spearman test and agreement using the kappa coefficient between the two classifications, initially using the general population of the study and then subdividing it into patients with and without bronchospasm and those with and without the use of neuromuscular blockers.

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Article Synopsis
  • Hypereosinophilic syndrome (HES) involves high eosinophil levels, excluding other causes, and can lead to serious organ damage, including affecting coronary arteries and causing vasospastic angina (VSA).
  • A 55-year-old woman with allergies and chest pain was found to have VSA due to spasms in her coronary arteries, with moderate eosinophilia during tests leading to a diagnosis of HES alongside eosinophilic pneumonia and chronic rhinosinusitis.
  • Treatment with corticosteroids rapidly alleviated her symptoms and reduced eosinophil counts, highlighting the efficacy of this therapy for addressing both the VSA and underlying HES.
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Respiratory muscles's thermographic analysis in asthmatic youth with and without bronchospasm induced by eucapnic voluntary hyperpnea.

Clin Physiol Funct Imaging

July 2024

Physical Education Department, Associated Postgraduate Program in Physical Education, Universidade de Pernambuco and Universidade Federal da Paraíba, Recife, Brazil.

Objective: To compare the thermographic pattern of regions of interest (ROI) of respiratory muscles in young asthmatics with and without bronchospasm induced by eucapnic voluntary hyperpnea (EVH).

Materials And Methods: Cross-sectional study carried out with 55 young (55% male and 45% females) aged 12.5 ± 3.

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Actinrelated protein 2/3 complex subunit 1B (ARPC1B) deficiency is an inborn error of immunity (IEI) characterized by a combination of immunodeficiency and immune dysregulation and classified as an IEI with allergic manifestations. Here, we describe two patients with pathogenic variants in the ARPC1B gene. The first patient presented with eczema and bronchospasm at six months of age.

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