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Related Experiment Videos

Hemodynamic pattern in anaphylactic shock with cardiac arrest.

F Nicolas, D Villers, Y Blanloeil

    Critical Care Medicine
    |February 1, 1984
    PubMed
    Summary

    Anaphylactic shock from modified fluid gelatin infusion caused dangerous hemodynamic changes. Maintaining adequate left ventricular filling pressure is crucial to prevent cardiac arrest during anaphylaxis.

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    Area of Science:

    • Anesthesiology
    • Critical Care Medicine
    • Immunology

    Background:

    • Anaphylaxis is a severe, life-threatening allergic reaction.
    • Modified fluid gelatin is a colloid plasma expander used in fluid resuscitation.
    • Anaphylactic or anaphylactoid shock can lead to rapid hemodynamic compromise.

    Observation:

    • A 41-year-old male experienced anaphylactic shock 9 minutes post-infusion of modified fluid gelatin.
    • Hemodynamic parameters monitored included mean arterial pressure (MAP), systemic vascular resistance index (SVRI), cardiac index (CI), and stroke index (SI).
    • A sharp decline in wedge pressure (WP) occurred after infusion cessation, preceding cardiac arrest.

    Findings:

    • The patient exhibited a significant fall in MAP and SVRI, alongside an increase in CI and SI during shock.

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  • Following fluid resuscitation cessation, a precipitous drop in left ventricular filling pressure (WP) was observed.
  • Cardiac arrest occurred without preceding arrhythmia, highlighting the critical role of filling pressures.

    • Implications:

    • This case underscores the importance of vigilant hemodynamic monitoring during anaphylaxis.
    • Maintaining adequate left ventricular filling pressure is vital for preventing cardiovascular collapse in anaphylactic shock.
    • Understanding gelatin-induced anaphylaxis is crucial for anesthetic and critical care management.