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- W2153726549 abstract "Chlorhexidine use is becoming increasingly common in the health care setting, particularly in the perioperative setting. Its anti-septic properties confer ubiquitous use, from pre-operative shower solutions to antiseptic skin preparation and urinary catheters and gels. An often overlooked source of exposure is in central venous catheters (CVCs), which, in the case of allergic individuals, can cause life-threatening anaphylaxis. First, we examine a near death reaction to chlorhexidine from a CVC placed in the OR after careful planning following a previous severe anaphylaxis in the same setting. Second, we evaluate reported cases of perioperative anaphylaxis to determine whether chlorhexidine allergic patients can be identified preoperatively. Third, we analyze the range of hospital and household products that might induce chlorhexidine sensitization. On two sequential attempts at surgery for malignant Schwannoma the patient experienced severe perioperative anaphylaxis requiring prolonged resuscitation due to the unrecognized presence of chlorhexidine in the CVC. Each insertion of a CVC resulted in a large, direct systemic exposure to the allergen. A review of chlorhexidine related perioperative anaphylaxis literature reveals that prior cutaneous reactions to chlorhexidine products are not uncommon. Perioperative anaphylaxis to chlorhexidine can be severe due to its unexpected presence in CVCs, which also confer an immediate, systemic antigenic exposure. We propose that all patients be asked about previous cutaneous reactions prior to surgery, and that positive histories be clarified with chlorhexidine specific IgE, prick skin testing or complete avoidance of chlorhexidine perioperatively. We describe several important hospital and household products that might induce chlorhexidine sensitization." @default.
- W2153726549 created "2016-06-24" @default.
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- W2153726549 date "2014-02-01" @default.
- W2153726549 modified "2023-09-26" @default.
- W2153726549 title "Chlorhexidine Impregnated Central Venous Lines: A Potentially Avoidable Cause Of Severe Perioperative Anaphylaxis" @default.
- W2153726549 doi "https://doi.org/10.1016/j.jaci.2013.12.122" @default.
- W2153726549 hasPublicationYear "2014" @default.
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