Experience in diagnosis and treatment of red man syndrome caused by vancomycin after cardiovascular surgery
OBJECTIVE To analyze the clinical symptoms and evolution process of red man syndrome(RMS)caused by vancomycin after cardiovascular surgery,and provide diagnostic and therapeutic basis for clinical treatment.METHODS Retro-spective analysis was made on 18 patients with RMS treated with vancomycin for anti-infection after cardiovascular surgery in Car-diothoracic Surgery Department of Nanjing Drum Tower Hospital from March 2016 to August 2022.The disease type,symptoms and evolution,vancomycin dose and blood concentration were analyzed,and the treatment methods and clinical outcomes of all the patients were recorded.RESULTS Among the 18 patients,17 were with infective endocarditis and aortic dissection.The inci-dence of RMS was related to the high concentration of vancomycin and the use of domestic vancomycin.In the early stage,two patients died due to edema and bleeding of digestive tract and airway mucosa,and the rest were cured and discharged after treat-ment.CONCLUSION RMS is a common complication of vancomycin anti-infection after cardiovascular surgery.We should pay attention to the selection of pure preparations and monitoring of blood drug concentration.Early occurrence of maculopapules requires drug withdrawal and hormone intervention to prevent dragging to angioneurotic edema,leading to respiratory obstruction and gastrointestinal bleeding,resulting in poor prognosis.
vancomycinred man syndromecardiovascular surgerydiagnosis and treatment experience
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