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Anesthetic management of toxic epidermal necrolysis: a report of two cases
Anaesthesia, Pain and Intensive Care ; 27(1):135-138, 2023.
Article in English | EMBASE | ID: covidwho-2284684
ABSTRACT
Toxic epidermal necrolysis (TEN), is an acute, life-threatening emergent disease involving the skin and mucous membranes with serious systemic complications. It is characterized by widespread epidermal sloughing. Drugs are the most common triggers of TEN, but infection, vaccination, radiation therapy and malignant neoplasms can all induce it in susceptible patients. We report two cases in whom a hair dye and a COVID-19 vaccine (BioNTech, Pfizer) were believed to be the causative agents. These patients have to undergo repeated debridements of the necrotic tissue. In this manuscript the anesthetic management of TEN patients is discussed. Detailed preoperative evaluation, aggressive fluid and electrolyte replacement, avoidance of hypothermia during debridement, minimizing anesthetic agents and limiting traumatic procedures are key points in the management.Copyright © 2023 Faculty of Anaesthesia, Pain and Intensive Care, AFMS. All rights reserved.
Keywords
Anesthesia, covid-19, Toxic epidermal necrolysis, Vaccine, adult, agitation, article, atopic dermatitis, bicarbonate blood level, body surface, burn unit, case report, central venous catheterization, chloride blood level, clinical article, coronavirus disease 2019/dt [Drug Therapy], coronavirus disease 2019/pc [Prevention], corticosteroid therapy, creatinine blood level, deep sedation, electrocardiography, erythema, female, follow up, glucose blood level, heart arrhythmia/dt [Drug Therapy], hospital admission, hospital discharge, human, human tissue, hypothermia, immunotherapy, inhalation anesthesia, jugular vein, lactose intolerance, mean arterial pressure, medical history, mouth edema, oral bleeding, oxygen saturation, patient transport, plasmapheresis, postoperative analgesia, postoperative pain/dt [Drug Therapy], potassium blood level, rash, room temperature, septic shock, sinus tachycardia, skin exfoliation, sodium blood level, surgical debridement, toxic epidermal necrolysis/dt [Drug Therapy], toxic epidermal necrolysis/si [Side Effect], toxic epidermal necrolysis/su [Surgery], tracheal extubation, urea nitrogen blood level, wakefulness, young adult, beta adrenergic receptor blocking agent/dt [Drug Therapy], bicarbonate/ec [Endogenous Compound], chloride/ec [Endogenous Compound], creatinine/ec [Endogenous Compound], cyclosporine/dt [Drug Therapy], fentanyl/cb [Drug Combination], fentanyl/na [Intranasal Drug Administration], glucose/ec [Endogenous Compound], hair dye/to [Drug Toxicity], immunoglobulin/dt [Drug Therapy], immunoglobulin/iv [Intravenous Drug Administration], infusion fluid, ketamine/cb [Drug Combination], ketamine/na [Intranasal Drug Administration], methylprednisolone/dt [Drug Therapy], methylprednisolone/iv [Intravenous Drug Administration], midazolam/cb [Drug Combination], midazolam/na [Intranasal Drug Administration], morphine/dt [Drug Therapy], morphine/iv [Intravenous Drug Administration], nitrogen/ec [Endogenous Compound], oxygen/ec [Endogenous Compound], potassium/ec [Endogenous Compound], propofol/cb [Drug Combination], propofol/na [Intranasal Drug Administration], sodium/ec [Endogenous Compound], tozinameran/ae [Adverse Drug Reaction], tozinameran/dt [Drug Therapy], urea/ec [Endogenous Compound], artificial skin, central venous catheter, endotracheal tube, wound dressing

Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: Anaesthesia, Pain and Intensive Care Year: 2023 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: Anaesthesia, Pain and Intensive Care Year: 2023 Document Type: Article