[Anaphylactic shock due to modified fluid gels: 2 case reports].

Area of Science:

• Anesthesiology and Critical Care Medicine
• Immunology

Background:

• Colloid plasma substitutes are widely used in medical settings.
• Potential for severe adverse events, including anaphylaxis, exists with certain colloid solutions.

Observation:

• Two cases are presented: a 68-year-old male experiencing hypotension and skin rash after Plasmion infusion, and a 12-year-old female developing bronchospasm and worsened hypotension.
• These reactions are attributed to immunologic mechanisms or direct histamine release.

Findings:

• Anaphylactic reactions to colloid solutions range from 0.01% to 0.8%.
• Prevention strategies include antihistaminic premedication for gelatin-based colloids and haptenic inhibition for dextran.
• Hydroxyethylstarch-based colloids appear to have a lower incidence of allergic reactions.

Implications:

• Awareness of potential anaphylaxis from colloid solutions is crucial for clinicians.
• Prophylactic measures can mitigate risks associated with gelatin and dextran plasma substitutes.
• Emerging hydroxyethylstarch colloids may offer a safer alternative for volume replacement.