{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T18:28:35Z","timestamp":1770748115027,"version":"3.49.0"},"reference-count":10,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T00:00:00Z","timestamp":1659312000000},"content-version":"vor","delay-in-days":31,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia Reports"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Serious intra\u2010operative anaphylactic shock is an unusual complication. Identification of causative agents can be difficult due to the number of anaesthetic drugs administered in quick succession, many of which can potentially cause anaphylaxis. Most anaphylactic reactions respond to, and resolve with, adrenaline and steroids. However, they can be prolonged and life\u2010threatening. Refractory anaphylaxis, unresponsive to repeated doses of adrenaline, is rare and associated with a high risk of mortality. Rupture of a hydatid cyst during surgery can cause anaphylaxis. Here, we present a rare case of refractory anaphylactic shock during surgical resection of a hepatic hydatid cyst, with severe haemodynamic instability requiring prolonged postoperative ventilation and triple inotropic support for seven\u2009days in the intensive care unit. We describe the management of this condition, primarily based on steroid therapy and escalating vasopressor support, particularly where limited response to adrenaline is encountered. Refractory anaphylaxis is a rare but life\u2010threatening complication of hydatid cyst surgery. Therefore, anaphylactic reactions should always be anticipated, with the appropriate treatment and facilities readily available.<\/jats:p>","DOI":"10.1002\/anr3.12183","type":"journal-article","created":{"date-parts":[[2022,8,2]],"date-time":"2022-08-02T00:04:08Z","timestamp":1659398648000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Peri\u2010operative refractory anaphylactic shock during hepatic hydatid cyst surgery"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9120-1574","authenticated-orcid":false,"given":"P.","family":"Gundappa","sequence":"first","affiliation":[{"name":"Department of Anaesthesia Manipal Hospital  Bangalore India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Prakash","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Manipal Hospital  Bangalore India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N.","family":"Palankar","sequence":"additional","affiliation":[{"name":"Department of General Surgery Manipal Hospital  Bangalore India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Karanth","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Manipal Hospital  Bangalore India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,8]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2018.04.014"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2020.08.015"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2019.02482"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2005.12.1303"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.3347\/kjp.2016.54.6.769"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.4254\/wjh.v6.i5.293"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.18203\/2349-2902.isj20181059"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e318267667b"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000082993.84883.7D"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e3181bbd443"}],"container-title":["Anaesthesia Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/anr3.12183","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/anr3.12183","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/anr3.12183","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T12:08:48Z","timestamp":1759925328000},"score":1,"resource":{"primary":{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/10.1002\/anr3.12183"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7]]},"references-count":10,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,7]]}},"alternative-id":["10.1002\/anr3.12183"],"URL":"https:\/\/doi.org\/10.1002\/anr3.12183","archive":["Portico"],"relation":{},"ISSN":["2637-3726","2637-3726"],"issn-type":[{"value":"2637-3726","type":"print"},{"value":"2637-3726","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7]]},"assertion":[{"value":"2022-07-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-08-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e12183"}}