IMPORTANCE 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.

中文翻译：

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氯己定相关的难治性过敏性休克：一例成功通过体外膜氧合复苏的病例。

重要信息我们报告患者对洗必泰涂层中央静脉导管发生危及生命的过敏反应，并确认其血清中的洗必泰特异性IgE水平较高。据我们所知，这是使用体外膜氧合（ECMO）成功复苏的第一例病例。使用氯己定和氯己定浸渍的导管时，必须格外小心，因为广泛使用该导管有可能使某些患者敏感，并可能在随后的暴露中导致危及生命的过敏反应。观察一名对氯己定造成致命性过敏性休克的单例患者的病例报告，该患者成功使用ECMO进行了复苏。结论我们设计了诊断和处理严重过敏反应的流程图。该病例报告强调了洗必太可能成为难治性过敏性休克发展的来源。我们建议ECMO可以挽救因洗必泰继发的严重支气管痉挛和难治性过敏性休克患者的生命。