title: Role of vasopressin in the treatment of anaphylactic shock in a child undergoing surgery for congenital heart disease: a case report.
abstract: BACKGROUND
  The incidence of anaphylactic reactions during anesthesia is between 1:5000 and 1:25000 and it is one of the few causes of mortality directly related to general anesthesia. The most important requirements in the treatment of this clinical condition are early diagnosis and maintenance of vital organ perfusion. Epinephrine administration is generally considered as the first line treatment of anaphylactic reactions. However, recently, new pharmacological approaches have been described in the treatment of different forms of vasoplegic shock.
  
  
  METHODS
  We describe the case of a child who was undergoing surgery for ventricular septal defect, with an anaphylactic reaction to heparin that was refractory to epinephrine infusion and was effectively treated by low dose vasopressin infusion.
  
  
  CONCLUSIONS
  In case of anaphylactic shock, continuous infusion of low-dose vasopressin might be considered after inadequate response to epinephrine, fluid resuscitation and corticosteroid administration.
authors.affiliation: Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Hospital, Rome, Italy. dichiaraluca@libero.it
authors.forename: Luca
authors.initials: L
authors.lastname: Di Chiara
authors.forename: Giulia V
authors.initials: GV
authors.lastname: Stazi
authors.forename: Zaccaria
authors.initials: Z
authors.lastname: Ricci
authors.forename: Angelo
authors.initials: A
authors.lastname: Polito
authors.forename: Stefano
authors.initials: S
authors.lastname: Morelli
authors.forename: Chiara
authors.initials: C
authors.lastname: Giorni
authors.forename: Ondina
authors.initials: O
authors.lastname: La Salvia
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Vitale
authors.forename: Eugenio
authors.initials: E
authors.lastname: Rossi
authors.forename: Sergio
authors.initials: S
authors.lastname: Picardo