PMID- 32030641
OWN - NLM
STAT- MEDLINE
DCOM- 20201113
LR  - 20201113
IS  - 2212-1358 (Electronic)
IS  - 2212-134X (Linking)
VI  - 8
IP  - 2
DP  - 2020 Apr
TI  - Anaphylaxis secondary to albumin infusion during posterior spinal fusion for 
      pediatric scoliosis.
PG  - 327-331
LID - 10.1007/s43390-020-00027-2 [doi]
AB  - STUDY DESIGN: Case report. OBJECTIVES: To describe intraoperative administration 
      of albumin as a cause of immunoglobulin E (IgE)-mediated anaphylaxis and cardiac 
      arrest in an adolescent with adolescent idiopathic scoliosis. BACKGROUND: Albumin 
      is considered the reference intraoperative colloidal solution, and is used 
      commonly as a volume expander for treating hypovolemia. Albumin rarely causes an 
      anaphylactic reaction, with a documented rate of only 0.099%. METHOD: An 
      adolescent with scoliosis experienced acute, intraoperative hypotension during 
      exposure for planned T5-L4 posterior spinal fusion shortly after infusion of 
      albumin. She was treated rapidly and successfully with CPR and epinephrine. 
      RESULTS: Intraoperative transesophageal echocardiogram, chest radiograph, and 
      serum histamine, serum tryptase, and urine N-methyl-histamine laboratory tests 
      confirmed albumin anaphylaxis to be the etiology of the intraoperative event. 
      Further postoperative complications were avoided as a result of the rapid 
      diagnosis and treatment. CONCLUSIONS: Although rare, IgE-mediated anaphylaxis to 
      albumin, if administered, must be considered a possible cause of acute, 
      intraoperative hypotension. Rapid management of anaphylaxis with communication 
      between the surgeon, anesthesia team, and operative staff are essential if 
      additional complications are to be avoided.
FAU - Daniel, Benjamin
AU  - Daniel B
AD  - School of Medicine, Medical College of Georgia, 1120 15th St, Augusta, GA, 30912, 
      USA.
FAU - Wanner, J P
AU  - Wanner JP
AD  - Department of Orthopaedic Surgery, Vanderbilt University Medical Center, 1211 
      Medical Center Dr, Nashville, TN, 37232, USA.
FAU - Emerson, Brian
AU  - Emerson B
AD  - Division of Pediatric Anesthesiology, Vanderbilt Children's Hospital, 2200 
      Children's Way, Nashville, TN, 37232, USA.
FAU - Martus, Jeffrey E
AU  - Martus JE
AD  - Division of Pediatric Orthopaedics, Vanderbilt Children's Hospital, 2200 
      Children's Way, Nashville, TN, 37232, USA. jeff.martus@vumc.org.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20200206
PL  - England
TA  - Spine Deform
JT  - Spine deformity
JID - 101603979
RN  - 0 (Albumins)
RN  - 37341-29-0 (Immunoglobulin E)
RN  - YKH834O4BH (Epinephrine)
SB  - IM
MH  - Acute Disease
MH  - Adolescent
MH  - Albumins/*administration & dosage/*adverse effects/immunology
MH  - Anaphylaxis/*diagnosis/*etiology/immunology/therapy
MH  - Cardiopulmonary Resuscitation
MH  - Early Diagnosis
MH  - Epinephrine/therapeutic use
MH  - Female
MH  - Humans
MH  - Hypotension/etiology
MH  - Immunoglobulin E
MH  - Intraoperative Care/*adverse effects
MH  - Intraoperative Complications/*diagnosis/*etiology/therapy
MH  - Intraoperative Period
MH  - Scoliosis/*surgery
MH  - Spinal Fusion/*methods
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Adolescent idiopathic scoliosis
OT  - Albumin
OT  - Anaphylaxis
OT  - Pediatric
OT  - Posterior spinal fusion
EDAT- 2020/02/08 06:00
MHDA- 2020/11/18 06:00
CRDT- 2020/02/08 06:00
PHST- 2019/05/19 00:00 [received]
PHST- 2019/07/28 00:00 [accepted]
PHST- 2020/02/08 06:00 [pubmed]
PHST- 2020/11/18 06:00 [medline]
PHST- 2020/02/08 06:00 [entrez]
AID - 10.1007/s43390-020-00027-2 [pii]
AID - 10.1007/s43390-020-00027-2 [doi]
PST - ppublish
SO  - Spine Deform. 2020 Apr;8(2):327-331. doi: 10.1007/s43390-020-00027-2. Epub 2020 
      Feb 6.