Anaphylactic shock due to vitamin K in a newborn and review of literature

Therapeutic effect of vitamin K1 combined with meropenem on the treatment of pertussis syndrome

Clinical efficacy of vitamin K1 combined with meropenem on the treatment of pertussis syndrome was evaluated. Clinical data of 170 children with pertussis syndrome treated in the Second People's Hospital of Liaocheng from March 2015 to March 2017 were collected. Of these, 87 patients who were treated with vitamin K1 combined with meropenem were regarded as the experiment group. A total of 83 patients who were treated with meropenem alone were regarded as the control group. Both groups were treated with anti-infective, respiratory support, antispasmodic, expectorant and other basic treatments. The therapeutic effects, duration of spasmodic cough, length of hospitalization, antipyretic time, duration of voice disappearance and healing time were observed between the two groups. The duration of spasmodic cough and length of hospitalization in the experiment were lower than the control group, and the difference was statistically significant between the groups (P<0.05). The explicit efficiency (51.72%) and total effective efficiency (99.55%) in the experiment group were significantly higher than the explicit efficiency (36.14%) and total effective efficiency (78.31%) in the control group. There was a statistically significant difference between the groups (P<0.05). The voice disappearance time and healing time in the experiment group were significantly shorter than the control group, and there was a statistically significant difference between the groups (P<0.05). The antipyretic time in the experiment group was lower than that of the control group, the difference between the groups was not statistically significant (P>0.05). The treatment with vitamin K1 and meropenem has a significant effect in relieving pediatric pertussis syndrome, it can shorten the duration of spasmodic cough, antipyretic time, duration of voice disappearance and length of hospitalization in children with pertussis syndrome, and improve the efficacy clinically.

Treatment of a long-acting anticoagulant rodenticide poisoning cohort with vitamin K1 during the maintenance period

Currently, there are few guidelines for the use of vitamin K1 in the maintenance treatment of long-acting anticoagulant rodenticide (LAAR) poisonings. We explored factors in the treatment of LAAR poisoning during the maintenance period in order to suggest feasible treatment models.Data from 24 cases of anticoagulant rodenticide poisoning in our hospital were collected from January 2013 to May 2016. The patients' sex, age, coagulation function, total time from poisoning to treatment with vitamin K1 (prehospital time), vitamin K1 sustained treatment time (VKSTT), anticoagulant rodenticide category, and specific poison dosage were collected. Multivariate analysis was used to evaluate the correlation between vitamin K1 dosage and other factors during the maintenance period.Only VKSTT (partial regression coefficient -1.133, 0.59, P = 0.035) had an obvious influence on the therapeutic dose of vitamin K1 required during the maintenance period.After an initial pulse therapy, the bleeding and coagulation functions were stabilized, and the patients were subsequently treated with vitamin K1 during the maintenance period. Over time, the maintenance dose of vitamin K1 (10-120 mg/d, intravenous drip) was gradually decreased and was not related to toxicant concentration.

A clinically suspected case of Anaphylactoid reaction to vitamin K injection in a child - a case report and review of literature

Vitamin K is commonly indicated in pediatric patients with coagulopathies. Its commercial preparations are available in the market since long. Minor complications are very well-known, but life-threatening events are rarely reported in children. We present a case of 8-year-old child who developed life-threatening event following intravenous Vitamin K injection. She was survived after cardiopulmonary resuscitation. The reaction was most probably due to anaphylactoid reaction to Vitamin K.

Characterizing the Severe Reactions of Parenteral Vitamin K1

Parenteral vitamin K1 (phytonadione) is used for anticoagulant reversal, and a boxed warning exists with intravenous and intramuscular administration due to the possibility of severe reactions, including fatalities. These reactions resemble hypersensitivity or anaphylaxis, including anaphylactoid reaction, and have led to shock and cardiac and/or respiratory arrest. The objective of this review is to summarize the available literature detailing the anaphylactic/anaphylactoid reactions with parenteral vitamin K1 in order to better characterize the reaction and provide a more in-depth understanding of its importance. A comprehensive literature search of MEDLINE (1946 to June 2016) and EMBASE (1947 to June 2016) was conducted using the terms vitamin K1, phytonadione, phytomenadione, vitamin K group, anaphylaxis, polyoxyethylated castor oil, and cremophor. A total of 2 retrospective surveillance studies, 2 retrospective cohort studies, and 17 case reports were identified for inclusion and assessment. Based on a review of the literature, use of parenteral vitamin K1 may result in severe hypotension, bradycardia or tachycardia, dyspnea, bronchospasm, cardiac arrest, and death. These reactions are most consistent with a nonimmune-mediated anaphylactoid mechanism. It appears that intravenous administration is more frequently associated with these reactions and occurs at an incidence of 3 per 10 000 doses of intravenous vitamin K1. The solubilizer may also increase the risk of adverse reactions, which occurred in patients with and without previous exposure to vitamin K1. Although there are known factors that increase the risk of an adverse drug event occurring, reactions have been reported despite all precautions being properly followed.