Management of cold-induced urticaria during cardiac surgery.

General body cooling and local hypothermia during cardiopulmonary bypass in theory could precipitate a severe systemic anaphylaxis in the case of cold-induced urticaria. We present a case of cold-induced urticaria and describe how preanesthetic single-dose steroid, H(2) antagonist, and antihistamine, normothermic retrograde, and antegrade cardioplegia administration were all employed with normothermic conditions in the prevention of life-threatening anaphylaxis during coronary artery bypass grafting.