Type I Anaphylactic Reaction Due To Contrast Induced Angioedema Causing Neck Swelling: The Role Of Sitting Fiberoptic Bronchoscopy In Emergent Intubation

Author(s):
Ali DabbaghAli DabbaghAli Dabbagh ORCID1,*, Habibollah SaadatHabibollah Saadat2, Mahnoosh ForoughiMahnoosh Foroughi2, Samira RajaeiSamira RajaeiSamira Rajaei ORCID3, Reza KhajenouriReza Khajenouri4, Farhad SolatpourFarhad Solatpour4, Abbas Arjmand ShabestariAbbas Arjmand Shabestari5, Taraneh Faghihi LangroudiTaraneh Faghihi Langroudi5, Hamid GhaderiHamid Ghaderi2
1Professor of Cardiac Anesthesia; Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2Cardiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3Immunology Department, Tehran University of Medical Sciences, Tehran, Iran
4Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
5Radiology Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran
*Corresponding Author: Professor of Cardiac Anesthesia; Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Email: [email protected]

Journal of Cellular & Molecular Anesthesia:Vol. 1, issue 3; e149514
Published online:Jul 23, 2016
Article type:Brief Communications
How to Cite:Dabbagh A, Saadat H, Foroughi M, Rajaei S, Khajenouri R, et al. Type I Anaphylactic Reaction Due To Contrast Induced Angioedema Causing Neck Swelling: The Role Of Sitting Fiberoptic Bronchoscopy In Emergent Intubation. J Cell Mol Anesth. 2016;1(3):e149514. doi: https://doi.org/10.22037/jcma.v1i3.12006

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 IgE 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.Keywords: airway management; type I anaphylactic reaction, angioedema; fiberoptic bronchoscope.Conflict of interest: none of the authors has any conflict of interest.

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© 2016, Author(s). This open-access article is available under the Creative Commons Attribution 4.0 (CC BY 4.0) International License (https://creativecommons.org/licenses/by/4.0/), which allows for unrestricted use, distribution, and reproduction in any medium, provided that the original work is properly cited.

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