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Professional paper

Epinephrine induced cardiomyopathy in a child with anaphylaxis

Andre Raszynski ; Division of Critical Care Medicine and Miami Children’s Hospital, Miami, USA
Madhuradhar Chegond ; Division of Critical Care Medicine and Miami Children’s Hospital, Miami, USA
Balagangadhar R Totapally ; Division of Critical Care Medicine and Miami Children’s Hospital, Miami, USA


Full text: english pdf 281 Kb

page 207-213

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Abstract

Transient cardiomyopathy is an uncommon occurrence in patients with anaphylaxis. Catecholamine induced direct toxicity is one of the proposed mechanisms. We report a case of cardiomyopathy in a child with anaphylaxis who was treated with multiple doses of epinephrine as well as a continuous infusion of epinephrine. A twenty one month old girl with egg allergy presented to our hospital with anaphylaxis, after multiple doses of epinephrine injections, developed cardiorespiratory dysfunction and required endotracheal intubation and mechanical ventilation. Work up showed depressed cardiac function, which improved with milrinone and furosemide infusions. Conclusion: Epinephrine is the treatment of choice for anaphylaxis however caution should be exercised when administering multiple doses of epinephrine. Myocardial function needs to be assessed in children with persistent hypotension after anaphylaxis and catecholamine-induced cardiomyopathy should be considered in children with anaphylaxis when severe myocardial dysfunction is present.

Keywords

anaphylaxis; epinephrine; cardiomyopathy; children

Hrčak ID:

170165

URI

https://hrcak.srce.hr/170165

Publication date:

1.5.2016.

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