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Related Experiment Videos

Severe anaphylactoid reaction to hydroxyethyl starch.

M J Cullen1, M Singer

  • 1Middlesex Hospital, London.

Anaesthesia
|December 1, 1990
PubMed
Summary

A severe anaphylactoid reaction to hydroxyethyl starch (HES) occurred during surgery, necessitating intensive care for breathing difficulties and low blood pressure. A later skin test suggested a complement-mediated hypersensitivity to HES.

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Area of Science:

  • Anesthesiology
  • Immunology
  • Pharmacology

Background:

  • Hydroxyethyl starch (HES) solutions are commonly used plasma volume expanders in peri-operative settings.
  • Adverse reactions to HES, though rare, can be severe and life-threatening.

Observation:

  • A patient experienced a severe peri-operative anaphylactoid reaction, characterized by bronchospasm and hypotension, following administration of HES.
  • The patient required prolonged intensive care management for stabilization.

Findings:

  • A subsequent intradermal injection of hetastarch (a type of HES) elicited a delayed positive skin test response.
  • This response suggests a potential complement-mediated hypersensitivity mechanism underlying the anaphylactoid reaction to HES.

Implications:

  • These findings highlight the importance of recognizing severe HES-associated anaphylactoid reactions.
  • Further investigation into complement activation pathways may elucidate the pathophysiology of HES hypersensitivity.
  • This case underscores the need for vigilance and alternative fluid management strategies in susceptible patients.

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