Allergic phenomena and coagulation abnormalities with colloids

Allergic reactions range from urticaria, the most common effect of gelatines, to severe anaphylaxis with cardiovascular collapse, more commonly seen with dextrans. The incidence of allergic reactions is low with any of the colloids (0-01%-0-05%).

Colloids affect coagulation through various mechanisms but these effects are rarely associated with clinical bleeding:

• A dilution coagulopathy is associated with any plasma substitute.

• Dextrans reduce the activities of factor V and VIII. These effects are more severe with higher molecular weights.

• Gelatines interfere with fibrin polymerisation and inhibit platelet aggregation.

• HES solutions interfere with Von Willebrand and factor VIII release and accelerates the conversion of fibrinogen to fibrin, which results in weaker clot formation.

Table 5.6 Contents and anaphylaxis rate of common colloids in mmol litre 1 (mg dl

Duration of

Table 5.6 Contents and anaphylaxis rate of common colloids in mmol litre 1 (mg dl

Duration of

Colloids

Na;

K+

Ca 2

CI

Osmolality

pH

volume effect*

Anaphylaxis (%)

Plasma

140

4

2-3 (9-2)

100

285-295

7-0

Gelofusine

154

0-4

0-4 (1-6)

125

279

7-4

1-2 hours

0-345

Haemaccel

145

5-1

6-25 (25)

145

301

7-3

1-2 hours

0-345

Dextran 70

0

0

0

0

287

5-0

1-2 hours

0-273

Albumin 4-5%

145

< 2

0

145

290

7-4

2-4 hours

0-099

Albumin 20%

145

< 2

0

145

290

7-4

2-4 hours

0-099

HES 6%

0

0

0

0

300

5-5

6-18 hours

0-058

Stored red cells Several days

Stored red cells Several days

*Varies depending on the volume status of the patient and the presence of capillary leak.

Was this article helpful?

0 0
Allergic To Everything

Allergic To Everything

The human body And Todays chemical infested world. Here is a news flash You are not allergic to pollen, pet dander, or whatever it is that makes your body revolt Rather, your body just can not handle that one thing, what ever it is, anymore, due to the massive barrage of toxic chemicals you and everyone else are ingesting every single day.

Get My Free Audio and Ebook


Post a comment