Vancomycin induced cardiac arrest: a case report

Area of Science:

• Pediatric Critical Care Medicine
• Pharmacology
• Clinical Toxicology

Background:

• Vancomycin is a critical antibiotic for treating serious Gram-positive bacterial infections.
• Rapid intravenous administration of vancomycin is associated with histaminergic reactions, including rash, pruritus, and hypotension.
• These reactions, collectively known as Red Man Syndrome, can range in severity.

Observation:

• A 9-year-old girl received vancomycin preoperatively for limb salvage surgery.
• Due to inadvertent rapid infusion, she developed flushing, pruritus, respiratory distress, and hypotension.
• This rapidly progressed to asystole, indicating a severe adverse event.

Findings:

• The patient experienced cardiac arrest following rapid vancomycin administration.
• Prompt cardiopulmonary resuscitation was initiated, leading to successful revival.
• The event was attributed to Red Man Syndrome secondary to rapid vancomycin infusion.

Implications:

• This case highlights the potentially life-threatening nature of Red Man Syndrome.
• It underscores the importance of controlled vancomycin infusion rates to prevent adverse events.
• Awareness and prompt management of vancomycin-induced reactions are vital for patient safety.