title: [Successful management after cardiopulmonary bypass without administration of protamine in a patient with severe food allergy--beneficial result with the use of heparin-coated bypass circuit].
abstract: We experienced the anesthetic management for cardiac surgery without the administration of protamine in a patient with severe food allergy. The patient, a 15-year-old boy, who had been avoiding many kinds of food including fish due to severe food allergy, received a correction of ventricular septal defect under cardiopulmonary bypass (CPB). To detect intraoperative drugs, including protamine, which might induce allergic reaction, we performed intradermal tests and prick tests. We used heparin-coated bypass circuit to minimize the amount of heparin necessary for anticoagulation during CPB. After CPB, hemostasis was achieved without the administration of protamine, and the patient received neither transfusion nor blood product throughout the perioperative period. Avoidance of protamine is advisable if the patient is allergic to food especially fish. The use of heparin-coated bypass circuit should be considered to establish hemostasis without protamine after CPB and to reduce blood products.
authors.affiliation: Department of Anesthesiology, National Cardiovascular Center, Suita 565-8565.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Sawai
authors.forename: Osamu
authors.initials: O
authors.lastname: Uchida
authors.forename: Shuji
authors.initials: S
authors.lastname: Inamori
authors.forename: Masakazu
authors.initials: M
authors.lastname: Kuro
mesh_terms: D000293:Adolescent; D000758:Anesthesia; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D020099:Coated Materials, Biocompatible; D000075202:Contraindications; D005396:Fish Products / Q000009:adverse effects*; D005512:Food Hypersensitivity; D006345:Heart Septal Defects, Ventricular / Q000601:surgery; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D019990:Perioperative Care; D011479:Protamines
chemical_list: D020099:Coated Materials, Biocompatible; D011479:Protamines; D006493:Heparin