Ultrasonic volume assessment-guided successful rescue of cardiac arrest caused by intraoperative severe anaphylactic shock: a case report

Abstract Background Perioperative anaphylaxis (POA) is a potentially life-threatening event. The incidence of POA is on the rise, but few case reports are available on cardiac arrest caused by post-anesthesia anaphylactic shock especially those successfully rescued under the guidance of ultrasonic v...

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Main Authors: Yin-guang Yao, Zhi-lan Dou, Fang Zheng, kai-lai Zhu, Jian-Wei Zhou, Jian Zhou, Chuan-Guang Wang
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Anesthesiology
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Online Access:https://doi.org/10.1186/s12871-025-03189-6
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author Yin-guang Yao
Zhi-lan Dou
Fang Zheng
kai-lai Zhu
Jian-Wei Zhou
Jian Zhou
Chuan-Guang Wang
author_facet Yin-guang Yao
Zhi-lan Dou
Fang Zheng
kai-lai Zhu
Jian-Wei Zhou
Jian Zhou
Chuan-Guang Wang
author_sort Yin-guang Yao
collection DOAJ
description Abstract Background Perioperative anaphylaxis (POA) is a potentially life-threatening event. The incidence of POA is on the rise, but few case reports are available on cardiac arrest caused by post-anesthesia anaphylactic shock especially those successfully rescued under the guidance of ultrasonic volume assessment. Case presentation We herein report a case of cardiac arrest caused by intraoperative anaphylactic shock. A patient was admitted to the hospital due to left lumbar pain for two days and was diagnosed with left renal and ureteral calculi accompanied by hydronephrosis and infection. She was scheduled to undergo transurethral flexible ureteroscopic lithotripsy for bilateral renal and ureteral calculi under general anesthesia. Refractory hypotension occurred intraoperatively, so vasoactive drugs were applied, but the effect was unsatisfactory and cardiac arrest occurred later. At that time, the patient did not develop common allergic symptoms such as rash. After cardiopulmonary resuscitation (CPR), the patient’s heart rate recovered, but she still presented with persistent hypotension. After the anesthesiologist carried out ultrasonic volume assessment-guided fluid resuscitation, the patient experienced systemic rash, in which case severe anaphylactic shock was confirmed. After epinephrine and antianaphylactic treatment were given, the patient’s vital signs tended to become stable, and the operation was successfully completed. Conclusion With the assistance of the medical team, we successfully rescued a patient with cardiac arrest caused by intraoperative severe anaphylactic shock under the guidance of ultrasonic volume assessment. The operation was successfully completed, and the patient was discharged two days postoperatively and had a good prognosis.
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spelling doaj-art-d777f087b4fe44c9bdd2be78a531be722025-08-20T03:04:07ZengBMCBMC Anesthesiology1471-22532025-07-012511710.1186/s12871-025-03189-6Ultrasonic volume assessment-guided successful rescue of cardiac arrest caused by intraoperative severe anaphylactic shock: a case reportYin-guang Yao0Zhi-lan Dou1Fang Zheng2kai-lai Zhu3Jian-Wei Zhou4Jian Zhou5Chuan-Guang Wang6Department of Anesthesia, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Municipal Central HospitalDepartment of Anesthesia, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Municipal Central HospitalDepartment of Anesthesia, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Municipal Central HospitalDepartment of Anesthesia, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Municipal Central HospitalDepartment of Anesthesia, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Municipal Central HospitalDepartment of Anesthesia, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Municipal Central HospitalDepartment of Anesthesia, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Municipal Central HospitalAbstract Background Perioperative anaphylaxis (POA) is a potentially life-threatening event. The incidence of POA is on the rise, but few case reports are available on cardiac arrest caused by post-anesthesia anaphylactic shock especially those successfully rescued under the guidance of ultrasonic volume assessment. Case presentation We herein report a case of cardiac arrest caused by intraoperative anaphylactic shock. A patient was admitted to the hospital due to left lumbar pain for two days and was diagnosed with left renal and ureteral calculi accompanied by hydronephrosis and infection. She was scheduled to undergo transurethral flexible ureteroscopic lithotripsy for bilateral renal and ureteral calculi under general anesthesia. Refractory hypotension occurred intraoperatively, so vasoactive drugs were applied, but the effect was unsatisfactory and cardiac arrest occurred later. At that time, the patient did not develop common allergic symptoms such as rash. After cardiopulmonary resuscitation (CPR), the patient’s heart rate recovered, but she still presented with persistent hypotension. After the anesthesiologist carried out ultrasonic volume assessment-guided fluid resuscitation, the patient experienced systemic rash, in which case severe anaphylactic shock was confirmed. After epinephrine and antianaphylactic treatment were given, the patient’s vital signs tended to become stable, and the operation was successfully completed. Conclusion With the assistance of the medical team, we successfully rescued a patient with cardiac arrest caused by intraoperative severe anaphylactic shock under the guidance of ultrasonic volume assessment. The operation was successfully completed, and the patient was discharged two days postoperatively and had a good prognosis.https://doi.org/10.1186/s12871-025-03189-6UltrasoundAnaphylactic shockCardiac arrestCefazolinCase report
spellingShingle Yin-guang Yao
Zhi-lan Dou
Fang Zheng
kai-lai Zhu
Jian-Wei Zhou
Jian Zhou
Chuan-Guang Wang
Ultrasonic volume assessment-guided successful rescue of cardiac arrest caused by intraoperative severe anaphylactic shock: a case report
BMC Anesthesiology
Ultrasound
Anaphylactic shock
Cardiac arrest
Cefazolin
Case report
title Ultrasonic volume assessment-guided successful rescue of cardiac arrest caused by intraoperative severe anaphylactic shock: a case report
title_full Ultrasonic volume assessment-guided successful rescue of cardiac arrest caused by intraoperative severe anaphylactic shock: a case report
title_fullStr Ultrasonic volume assessment-guided successful rescue of cardiac arrest caused by intraoperative severe anaphylactic shock: a case report
title_full_unstemmed Ultrasonic volume assessment-guided successful rescue of cardiac arrest caused by intraoperative severe anaphylactic shock: a case report
title_short Ultrasonic volume assessment-guided successful rescue of cardiac arrest caused by intraoperative severe anaphylactic shock: a case report
title_sort ultrasonic volume assessment guided successful rescue of cardiac arrest caused by intraoperative severe anaphylactic shock a case report
topic Ultrasound
Anaphylactic shock
Cardiac arrest
Cefazolin
Case report
url https://doi.org/10.1186/s12871-025-03189-6
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