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The Korean Journal of Critical Care Medicine > Volume 27(3); 2012 > Article
The Korean Journal of Critical Care Medicine 2012;27(3): 187-190.
doi: https://doi.org/10.4266/kjccm.2012.27.3.187
Gadolinium 조영제와 경구 Propranolol을 사용한 환자에서 발생한 급성호흡곤란증후군을 동반하는 아나필락시양 반응 1예 -증례 보고-
김정현ㆍ김경호ㆍ정혜철ㆍ김은경ㆍ이지현
차의과학대학교 분당차병원 호흡기내과
A Case of Anaphylactoid Reaction to Gadolinium Contrast Media and Propranolol Complicated with Acute Respiratory Distress Syndrome (ARDS): A Case Report
Jung Hyun Kim, Kyung Ho Kim, Hye Cheol Jeong, Eun Kyung Kim, Ji Hyun Lee
Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea. plmjhlee@cha.ac.kr
ABSTRACT
Anaphylaxis/anaphylactoid reaction is a medical emergency. In rare cases, acute respiratory distress syndrome (ARDS) can complicate this disorder. This is a case report of an anaphylactoid reaction complicated with ARDS that was successfully treated using extracorporeal membrane oxygenation (ECMO). A 52-year-old female patient developed sudden dyspnea immediately after she received gadolinium contrast injection and 80 mg of oral propranolol. She progressed rapidly to a state of shock and her chest radiograph showed pulmonary edema. The shock and pulmonary edema did not respond to epinephrine or steroid injection. On the next day, the permeability edema worsened and laboratory test revealed extreme hemoconcentration. The oxygenation goal was not achieved with mechanical ventilation alone, thus ECMO was applied as well. The patient showed clinical improvements on the 3rd day and was weaned from ECMO on the 4th day. She was completely recovered from shock and respiratory distress by day 5. The patient was discharged from hospital without further complications.
Key Words: anaphylaxis; respiratory distress syndrome; extracorporeal membrane oxygenation; gadolinium; propranolol
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