Incidence and clinical importance of perioperative histamine release: randomised study of volume loading and antihistamines after induction of anaesthesia
TL;DR: The histamine-related disturbances under anaesthesia were remarkable for their severity (even with small rises in histamine concentrations), for the prevalence of bradycardia, and for the absence of skin signs.
About: This article is published in The Lancet.The article was published on 1994-04-16 and is currently open access. It has received 136 citations till now. The article focuses on the topics: Antihistamine & Haemaccel.
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Dissertation•
08 Jul 2013
TL;DR: In this paper, the authors compare the effets of trois types de remplissage administres en association avec l'adrenaline au cours du choc anaphylactique, demontrant la superiorite de l'administration de solute macromoleculaires tels que l'HES and l'echec des solutes sales hypertoniques.
Abstract: Le but de notre travail etait d'etudier des nouveaux aspects de la physiopathologie et de la therapeutique du choc anaphylactique chez le rat Brown Norway.
La premiere partie de notre these etudie la physiopathologie systemique et regionale du choc anaphylactique. Le choc anaphylactique s'accompagne d'une diminution rapide du debit cardiaque, d'une alteration brutale de l'autoregulation du debit sanguin cerebral et d'une atteinte respiratoire associant un oedeme des voies respiratoires et un bronchospasme.
La deuxieme partie de notre travail s'interesse a la prise en charge therapeutique du choc anaphylactique. L'adrenaline s'avere superieure a la vasopressine, pour inhiber le bronchospasme et diminuer la permeabilite microvasculaire, permettant une meilleure preservation de l'oxygenation cerebrale, en particulier dans la region de l'hippocampe, mais aussi une correction du bronchospsme et une diminution de l'hyperpermeabilte bronchique a la phase precoce du choc anaphylactique. Nous avons egalement compare les effets de trois types de solutes de remplissage administres en association avec l'adrenaline au cours du choc anaphylactique, demontrant la superiorite de l'administration de solute macromoleculaires tels que l'HES et l'echec des solutes sales hypertoniques. Enfin nous avons pu mettre en evidence l'interet de l'administration de bleu de methylene (3mg/kg) en demontrant l'existence d'un effet synergique avec l'adrenaline au cours du choc anaphylactique
6 citations
TL;DR: Hybrid molecules combining the crucial structural features of both pheniramine-type histamine H1 receptor antagonists and guanidinothiazole-type H2 receptor antagonists have been synthesized and tested for in vitro pharmacological activity at the isolated ileum and the spontaneously beating right atrium of the guinea-pig.
6 citations
6 citations
01 Jan 1998
TL;DR: Well balanced plasma volume support is essential in the clinical therapy of critically ill patients and patients undergoing elective or acute surgical procedures to maintain/achieve normovolaemia, haemodynamic stability, and adequate microvascular blood flow.
Abstract: Well balanced plasma volume support is essential in the clinical therapy of critically ill patients and patients undergoing elective or acute surgical procedures. The main objectives of the volume support are to maintain/achieve normovolaemia, haemodynamic stability, and adequate microvascular blood flow. An optimal fluid regimen should not include any obvious risk of excessive increases in tissue hydration, whereby microvascular blood flow may be jeopardized due to oedema induced compression of capillaries. The infusion of vast quantities of balanced salt solutions for plasma volume support may include such disadvantages due to the poor intravascular retention of a crystalloid [1]. When colloid containing solutions are infused, the presence of oncotically active macromolecules, which do not easily cross capillary membranes, will considerably reduce the total fluid volume requirements for adequate plasma volume support [1]. Therefore, plasma volume replacement with colloids is usually advantageous in many clinical situations [1, 2].
5 citations
References
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Journal Article•
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2,147 citations
TL;DR: 80 reports of randomised clinical trials in four leading general medical journals were reviewed and the reporting of the methodology of randomisation was inadequate, and the handling of comparisons of baseline characteristics was inadequate.
473 citations
TL;DR: The electrocardiographic changes consistent with ischemia during the 4 day perioperative period were documented and characterized in 100 patients with or at risk for coronary artery disease undergoing noncardiac surgery and postoperative ischemic episodes were the most severe.
321 citations
TL;DR: Pancuronium is suggested to be the least likely currently available agent to provoke a major anaphylactoid reaction and Predisposing factors in patients sensitive to muscle relaxants were: female sex, previous allergy and atopy.
Abstract: Sixty one patients who had suffered intra-operative anaphylactoid reactions were studied. Intradermal testing identified the causative agent in 84% of cases and, in 75% of these, muscle relaxants were responsible. Predisposing factors in patients sensitive to muscle relaxants were: female sex, previous allergy and atopy. The incidence of previous exposure was considerably higher than that reported in the literature. Pancuronium is suggested to be the least likely currently available agent to provoke a major anaphylactoid reaction.
130 citations
TL;DR: The effects of increasing concentrations of three opioids were studied on the release of preformed and de novo synthesized chemical mediators from human peripheral blood basophils and mast cells isolated from skin tissues or lung parenchyma.
Abstract: Opioids differ in their capacity to cause release of histamine. The effects of increasing concentrations of three opioids (morphine, buprenorphine, and fentanyl) were studied on the release of preformed (histamine and tryptase) and de novo synthesized (prostaglandin D2 [PGD2] and peptide-leukotriene C4 [LTC4]) chemical mediators from human peripheral blood basophils and mast cells isolated from skin tissues or lung parenchyma. Basophils released < 5% of their histamine content and did not synthesize significant amounts of LTC4 when incubated with any of the opioids. Mast cells showed markedly different responses to the three opioids. Morphine (10(-5)-3 x 10(-4) M), in a concentration-dependent manner, induced histamine and tryptase release from skin but not from lung mast cells, up to a maximum of 18.2 +/- 1.9% and 13.0 +/- 4.1 micrograms/10(7) cells, respectively. Morphine did not induce de novo synthesis of PGD2 from skin mast cells. Buprenorphine (10(-6)-10(-4) M), in a concentration-dependent manner, caused histamine and tryptase release from lung but not from skin mast cells, to a maximum of 47.6 +/- 7.2% and 35.1 +/- 13.6 micrograms/10(7) cells, respectively. Buprenorphine also induced de novo synthesis of PGD2 and LTC4 from lung mast cells. Fentanyl (10(-5)-10(-3) M) did not induce histamine and tryptase release or the de novo synthesis of PGD2 or LTC4 from any mast cells. Histamine release caused by buprenorphine from lung mast cells was slow (t1/2 = 11.2 +/- 3.6 min) compared with that induced by morphine from skin mast cells (t1/2 < 1 min, P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
113 citations