Cardiac arrest caused by nafamostat mesilate.
Cardiac arrest caused by nafamostat mesilate.
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DOI：
10.1016/j.krcp.2015.10.003
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发表时间：
2016-09
影响因子：
3
通讯作者：
Noh, Hyunjin
中科院分区：
文献类型：
--
作者：
Kim, Hyo Shik;Lee, Kyung Eun;Oh, Ji Hyun;Jung, Chan Sung;Choi, Dughyun;Kim, Yunsuek;Jeon, Jin Seok;Han, Dong Cheol;Noh, Hyunjin
一名65岁的男性因血液透析期间心脏骤停从血管外科转到肾脏科。他接受了切开引流治疗臀部脓肿。甲磺酸萘莫司他用作血液透析的抗凝剂，以解决切口和引流部位出血。透析15分钟后发生心脏骤停。患者在重症监护室接受治疗5天。在重症监护室开始连续静脉-静脉血液透析滤过，未使用任何抗凝剂。重新开始常规血液透析，由于少量持续出血，再次使用甲磺酸萘莫司他。血液透析后10分钟，患者主诉过敏性体征和症状，如呼吸困难、低血压和面部肿胀。在怀疑过敏性休克的情况下，注射肾上腺素、地塞米松和非那敏，患者痊愈。总免疫球蛋白E滴度高，皮肤点刺试验显示甲磺酸萘莫司他弱阳性。我们首先报告一例过敏性休克引起的萘莫司他甲磺酸在韩国。
A 65-year-old man was transferred from the Department of Vascular Surgery to Nephrology because of cardiac arrest during hemodialysis. He underwent incision and drainage for treatment of a buttock abscess. Nafamostat mesilate was used as an anticoagulant for hemodialysis to address bleeding from the incision and drainage site. Sudden cardiac arrest occurred after 15 minutes of dialysis. The patient was treated in the intensive care unit for 5 days. Continuous veno-venous hemodiafiltration was started without any anticoagulant in the intensive care unit. Conventional hemodialysis was reinitiated, and nafamostat mesilate was used again because of a small amount of continued bleeding. Ten minutes after hemodialysis, the patient complained of anaphylactic signs and symptoms such as dyspnea, hypotension, and facial swelling. Epinephrine, dexamethasone, and pheniramin were injected under the suspicion of anaphylactic shock, and the patient recovered. Total immunoglobulin E titer was high, and skin prick test revealed weak positivity for nafamostat mesilate. We first report a case of anaphylactic shock caused by nafamostat mesilate in Korea.