MAN-LING WANGChang, Ching-TaoChing-TaoChangHSING-HAO HUANGYU-CHANG YEHTZONG-SHIUN LEEKUAN-YU HUNG2021-08-202021-08-2020160952-8180https://www.scopus.com/inward/record.uri?eid=2-s2.0-84980008574&doi=10.1016%2fj.jclinane.2016.07.002&partnerID=40&md5=9e87401b95341aa35b00dd6ff3d7c39dhttps://scholars.lib.ntu.edu.tw/handle/123456789/578430Importance We report a patient with a life-threatening anaphylactic reaction to a chlorhexidine-coated central venous catheter, confirmed with a high serum level of chlorhexidine-specific IgE. To our knowledge, this is the first case successfully resuscitated using extracorporeal membrane oxygenation (ECMO). Great caution is required when using chlorhexidine and chlorhexidine-impregnated catheters, given that its widespread use has the potential to sensitize certain patients and may result in life-threatening anaphylaxis on subsequent exposure. Observations A case report of a single patient with life-threatening anaphylactic shock to chlorhexidine, who was successfully resuscitated using ECMO. Conclusions We have designed a flowchart for the diagnosis and management of severe anaphylaxis. This case report highlights the potential for chlorhexidine to be a source for the development of refractory anaphylactic shock. We suggest that ECMO may save the lives of patients with severe bronchospasm and refractory anaphylactic shock secondary to chlorhexidine. ? 2016 Elsevier Inc.Anaphylaxis; Central venous catheters; Chlorhexidine; Extracorporeal membrane oxygenation[SDGs]SDG3adrenalin; antibiotic agent; chlorhexidine; cisatracurium; creatine kinase; creatine kinase MB; fentanyl; heparin; hetastarch; immunoglobulin E; methylprednisolone; propofol; sulfadiazine silver; troponin I; tryptase; chlorhexidine; immunoglobulin E; topical antiinfective agent; abdominal abscess; abscess drainage; adult; airway pressure; anaphylaxis; antibiotic therapy; anticoagulant therapy; arterial gas; artery catheter; Article; artificial ventilation; blood pressure monitoring; bradycardia; capillary leak syndrome; case report; central venous catheter; chondroma; clivus chondroma; coronary artery disease; coughing; creatine kinase blood level; disease severity; electric activity; electrocardiogram; end tidal carbon dioxide tension; extracorporeal oxygenation; extubation; general anesthesia; heart muscle ischemia; heart output; hospital admission; human; hypercapnia; hypertension; hypokinesia; hypotension; intraoperative period; intubation; male; medical history; middle aged; pericardial effusion; positive end expiratory pressure; priority journal; pulmonary hypertension; resuscitation; shock; ST segment elevation; tachycardia; tidal volume; tracheostomy; transluminal coronary angioplasty; transthoracic echocardiography; adverse effects; anaphylaxis; blood; chemically induced; immunology; procedures; resuscitation; Anaphylaxis; Anesthesia, General; Anti-Infective Agents, Local; Central Venous Catheters; Chlorhexidine; Chondroma; Extracorporeal Membrane Oxygenation; Humans; Immunoglobulin E; Male; Middle Aged; Resuscitationjournal article10.1016/j.jclinane.2016.07.002276874652-s2.0-84980008574