Relationship between Tryptase and Hypotension in Anaphylaxis during Anesthesia

Area of Science:

• Anesthesiology
• Immunology
• Cardiovascular Medicine

Background:

• Hypotension is a key symptom of anaphylaxis, impacting its severity.
• Understanding hypotension characteristics during anaphylaxis is crucial but requires further elucidation.
• This study examines hypotension during anesthesia-induced anaphylaxis, focusing on tryptase and histamine.

Purpose of the Study:

• To investigate the characteristics of hypotension during anesthesia-induced anaphylaxis.
• To explore the relationship between hypotension, tryptase, and histamine levels.
• To assess the correlation between hypotension and anaphylaxis severity.

Main Methods:

• Retrieved minimum systolic blood pressure from anesthesia records for anaphylaxis patients (World Allergy Organization criteria).
• Analyzed tryptase and histamine levels post-anaphylaxis onset.
• Correlated blood pressure, tryptase, histamine, and anaphylaxis severity.

Main Results:

• Anaphylaxis occurred in 0.045% of patients (25/55,996) during anesthesia.
• Minimum systolic blood pressure <90 mmHg was observed in anaphylaxis patients.
• Lower systolic blood pressure correlated inversely with tryptase levels and anaphylaxis severity.

Conclusions:

• Hypotension during anaphylaxis is indicative of its severity.
• Tryptase may serve as a diagnostic aid for hypotension and a severity indicator for anaphylaxis.
• Further large-scale studies are recommended for validation.