• Man-Ling Wang, Ching-Tao Chang, Hsing-Hao Huang, Yu-Chang Yeh, Tzong-Shiun Lee, and Kuan-Yu Hung.
• Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.
• J Clin Anesth. 2016 Nov 1; 34: 654-7.

ImportanceWe 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.ObservationsA case report of a single patient with life-threatening anaphylactic shock to chlorhexidine, who was successfully resuscitated using ECMO.ConclusionsWe 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.Copyright © 2016 Elsevier Inc. All rights reserved.

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