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Kinin-mediated anaphylactoid reaction implicated in acute intra-operative pulseless electrical activity
S O'Sullivan1, J P McElwain, T S Hogan
1Department of Respiratory Medicine, James Connolly Memorial Hospital, Dublin 15, Ireland.
Anaesthesia
|August 9, 2001
Abstract:
A 65-year-old patient undergoing total hip replacement under general anaesthesia suffered acute pulseless electrical activity with a fatal outcome. A kinin-mediated analphylactoid reaction following administration of a polygeline plasma expander (Haemaccel) was implicated by in vitro testing. This case report illustrates the diagnostic difficulties posed by non-histaminoid anaphylactoid reactions and the resistance to epinephrine of kinin-mediated hypotension.