Combined use of ECMO and hemodialysis in the case of contrast-induced biphasic anaphylactic shock

摘要

Anaphylactic shock is the most critical iodine contrast media-mediated adverse reaction. Although nonionic iodine contrast media is widely used and is less likely to induce adverse reactions compared with ionic contrast media, patients with a history of contrast-induced allergic reactions provide a dilemma to interventional cardiologists because of the greater risk of nonionic or ionic contrast media-induced allergic reactions [1]. Most episodes of anaphylaxis develop early and resolve completely with appropriate treatment; however, approximately 10%-20% of these cases present with delayed onset of symptoms, follow a biphasic or protracted course, and create a very critical situation that requires immediate intervention [2,3]. We herein report a critical case of iodine contrast media-induced biphasic anaphylactic shock that required extracorporeal membrane oxygenation (ECMO) for hemodynamic stabilization with hemodialysis to retrieve contrast media.