Characteristics of myocardial injury and predictive factors of mortality in patients with severe anaphylaxis

Anaphylaxis is an allergic reaction. When the body exposed to heterogeneous, it stimulates mast cells and basophils to release chemical mediators, effects the body's organs: skin, mucous membranes, gastrointestinal system, respiratory system, especially the cardiovascular system, causes vasodilation, increased vascular permeability. Chemical mediators also causing coronary spasm, arrhythmia and decreased myocardial contractility. Therefore, early assessment of myocardial injury in this patients is essential in the treatment and prognosis. Patients and methods A prospective study in severe anaphylaxis patients in Center for Critical Care, Bach Mai hospital from 1/2021 to 10/2022. Demographic data including age, gender and SOFA score, anaphylactic characteristics, ABG, electrocardiogram… Group comparison analysis were used to investigated the relationship of predicting factors. Results In the study, there were 99 patients, with 38.4% myocardial injury (38/99). In myocardial injury group, with average age 32,9 ± 11,3 years, female was 84,2%. Most causes of anaphylaxis are drugs 89.5% (34/38). Patients have no history of allergies are 84.2%, anaphylaxis symptoms often begin within 5 to 30 min of heterogeneous exposure (71,1%). Discussions In our study, 38.4% of anaphylaxis patients had myocardial injury. In these patients, at the time of admission, they often present severe shock, in some cases with cardiac arrest and life-threatening arrhythmias requiring intensive resuscitation intervention. 15 patients were performed ECMO with high survival rate. However, 13.2% of patients died, the prognostic factors for mortality included: cardiac arrest, severe MOF and high serum lactate at the time of admission. Conclusion There are 38.4% of patients with severe anaphylaxis with myocardial injury, 13.2% of patients died, the prognostic factors included: cardiac arrest, severe MOF and high serum lactate at the time of admission