• A&A practice · Mar 2018

    Anaphylaxis to Surgiflo During Posterior Spinal Fusion in an Adolescent Status Post Truncus Arteriosus Repair: A Case Report.

    • Ana Maria Manrique Espinel, Jeffrey M Feldman, Susan Nelson, Tatiana Smaliak, John M Flynn, and Susan C Nicolson.
    • From the Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pennsylvania; Division of Cardiothoracic Anesthesiology, Department of Anesthesiology & Critical Care Medicine, General Anesthesiology, Division of Orthopaedic Surgery, and Cardiac Center Operations, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
    • A A Pract. 2018 Mar 15; 10 (6): 129-132.

    AbstractAnaphylactic reaction to gelatin-containing hemostatic agents has been reported in the orthopedic literature, most commonly during scoliosis repair in adolescents. However, the risk, differential diagnosis, and management of anaphylaxis in patients with complex congenital heart disease undergoing noncardiac procedures have not been previously reported. We describe the case of an adolescent with a history of repaired truncus arteriosus undergoing posterior spinal fusion who developed sudden and profound hypotension that was ultimately confirmed to be an anaphylactic reaction to Surgiflo. Echocardiography was used to aid in diagnosis and management of the cardiovascular effects of anaphylaxis in this patient with residual cardiac pathophysiology.

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