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[Heart arrest during dextran infusion despite hapten blockade]
Anasthesie, Intensivtherapie, Notfallmedizin
|February 1, 1984
Summary
Severe adverse reactions to dextran, a colloidal polysaccharide, can occur even with prophylactic measures. This prospective study found a 0.9% incidence of bronchospasm and cardiac arrest during dextran infusion.
Area of Science:
- Anesthesiology
- Pharmacology
- Immunology
Background:
- Colloidal polysaccharides like dextran are used as plasma volume expanders.
- Prophylactic hapten blockage with monovalent dextran-1 is recommended to prevent hypersensitivity reactions.
- Prospective clinical studies are crucial for determining the incidence of adverse events.
Observation:
- A 69-year-old patient experienced bronchospasm and cardiac arrest during dextran infusion, despite receiving dextran-1 prophylaxis.
- The patient was successfully resuscitated and underwent surgery under general anesthesia without sequelae.
- This event occurred in a running clinical prospective study involving 300 participants.
Findings:
- The incidence of severe adverse reactions to dextran in the studied sample was approximately 0.9% (95% confidence interval: 0.02% to 4.96%).
- Clinical symptoms were sufficient for diagnosing a dextran adverse reaction, as per protocol.
- Dextran was identified as the causative agent in this case.
Implications:
- The findings suggest a significant incidence of severe dextran-related adverse reactions, necessitating careful patient monitoring.
- Further continuation of the study may yield more data to refine the incidence rate and risk assessment.
- This case highlights the importance of recognizing clinical signs of dextran hypersensitivity even with prophylactic measures.