ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG CỦA BỆNH NHÂN SỐC PHẢN VỆ KHÔNG ĐÁP ỨNG VỚI THUỐC VẬN MẠCH - CƯỜNG TIM LIỀU CAO ĐIỀU TRỊ TẠI BỆNH VIỆN QUÂN Y 175

Abstract

Objective: To describe the clinical and paraclinical characteristics of patients with refractory anaphylactic shock unresponsive to high-dose vasopressor and inotropic therapy at Military Hospital 175.

Subjects and Methods: A prospective descriptive study with analytical components was conducted on 54 patients diagnosed with refractory anaphylactic shock unresponsive to high-dose vasopressor and inotropic therapy at Military Hospital 175 from December 2022 to October 2025.

Results: Among 54 patients, 59.3% were male, and the mean age was 56.2 ± 17.8 years. The leading cause was drug-induced anaphylaxis (51.9%), and 55.6% of cases occurred in the hospital setting. All patients presented with hypotension, and 75.9% developed respiratory failure. The mean lactate level was 5.6 ± 2.3 mmol/L, and mean arterial pH was 7.28 ± 0.08. All patients required two or more vasopressor agents, 70.4% required invasive mechanical ventilation, and the mortality rate was 24.1%. Lactate > 6 mmol/L, SpO₂ < 90%, and absence of cutaneous manifestations were significantly associated with mortality (p < 0.05).

Conclusion: Refractory anaphylactic shock unresponsive to high-dose vasopressor and inotropic therapy is characterized by severe clinical manifestations, frequently requiring advanced organ support, and is associated with a substantial mortality rate. Lactate > 6 mmol/L, SpO₂ < 90%, and absence of cutaneous signs are significant predictors of mortality.