Colloid infusion products used as a plasma expander may cause anaphylaxis during surgery (Thong and Ye-ow-Chan 2004). The exact pathophysiologic mechanisms are unclear. Gelatin-specific IgE and positive skin prick test as well as positive intradermal test have been demonstrated in some cases, suggesting an IgE-mediated mechanism (Laxenaire et al. 1994).
In a prospective multicenter trial, 69 cases of nonal-lergic anaphylaxis were observed among 200,906 infusions of colloid volume substitutes. The frequency of severe reactions such as shock, cardiac, or respiratory arrest was 0.003% for plasma-protein solutions, 0.006% for hydroxyethyl starch, 0.008% for dextran, and 0.038% for gelatin solutions (Ring and Messmer 1977).
Was this article helpful?