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Type I Anaphylactic Reaction Due to Contrast Induced Angioedema Causing Neck Swelling: Role of Sitting Fiberoptic Bronchoscopy in Emergent Intubation Publisher



Dabbagh A1 ; Saadat H2 ; Foroughi M2 ; Rajaei S3 ; Khajenouri R1 ; Solatpour F1 ; Shabestari AA4 ; Langroudi TF4 ; Ghaderi H3
Authors
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Authors Affiliations
  1. 1. Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  2. 2. Cardiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  3. 3. Immunology Department, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Radiology Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Source: Journal of Cellular and Molecular Anesthesia Published:2016


Abstract

Contrast induced angioedema is a rapidly progressive state involving a number of organ systems, including the upper airway tract; which is usually a type I anaphylactic reaction also known as immediate hypersensitivity reaction. Prompt preservation of the respiratory tract is the cornerstone of this situation. The use of fiberoptic bronchoscope for tracheal intubation though very helpful, has some special considerations due to the anatomic distortions created by edema. This manuscript describes a patient with contrast induced angioedema managed successfully. Serum levels of immunoglobulin E were highly increased during the first hours after the event; while serum levels of complement were normal. However, rapid airway management and prophylactic intubation saved the patient and prevented the possible aftermath of airway obstruction. © 2016 Shahid Beheshti University of Medical Sciences,  Anesthesiology Research Center. All Rights Reserved.
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