Related Experiment Video
Updated: Jul 6, 2026

Induction of Nephrotic Syndrome in Mice by Retrobulbar Injection of Doxorubicin and Prevention of Volume Retention by Sustained Release Aprotinin
Published on: May 6, 2018
[Case of aprotinin-induced anaphylactic shock]
Yuko Fujiwara1, Shogo Matsuura, Kazuhiko Fukuda
1Department of Anesthesia, Kyoto University Hospital, Kyoto 606-8507.
Abstract:
We report a case of anaphylactic shock caused by repeated use of aprotinin. Following re-administration of aprotinin at the beginning of repeated mitral valve replacement, the patient fell into shock state probably induced by anaphylactic reactions. Immediately, bispectral index (BIS) decreased from 40 to 5, and near-infrared spectroscopy showed regional tissue oxygen saturation (rSO2) of frontal head decreasing from 64/56% (left/right) to 26/36%. Despite massive use of inotropes, the blood pressure, BIS and frontal rSO2 were not improved. After the immediate initiation of cardiopulmonary bypass, the perfusion pressure increased to 40 mmHg, and BIS and frontal rSO2 recovered to 45 and 70/61%, respectively. The patient had no significant neurological sequela after the surgery. We conclude that parallel changes of BIS and frontal rSO2 reflect acute global cerebral ischemia, and these parameters may be useful for decision making in the treatment of shock patients.
Related Concept Videos
Allergic Reactions: Anaphylaxis
Allergic Reactions
Anticholinesterase Agents: Poisoning and Treatment
Irreversible agents form a strong bond with the cholinesterase enzyme, making it inactive. The breakdown of the phosphorylated enzyme is slower than the...
Adrenergic Agonists: Therapeutic Uses
Emergency and Intensive Care Unit (ICU) applications: Pressor agents increase blood pressure, heart rate, and contractility in shock and organ failure situations. Dopamine can induce vasodilation and stimulate adrenoceptors. Endogenous catecholamines are effective in treating cardiogenic shock. α2-agonists like clonidine can reverse anesthesia-induced hypertension.
Allergies and anaphylaxis:...
Drug Toxicity: Allergic Reactions
Hypersensitivity Reactions: Cytolytic Reactions
