Histamine release as cause of acute hypotension following rapid colloid infusion

Abstract

Summary. In a series of 133 dogs, 10--20 ml/kg arterial blood were removed and replaced by rapid intravenous infusion of an equivalent volume of various plasma substitutes. Following the infusion of gelatine solutions, an acute fall in arterial blood pressure was observed, but not following the infusion of equal quantities of Dextran 60 or of 0.90/0 NaC1 solution, lVieasurement of the blood histamine levels as well as the fact that the circulatory effects could be modified by the previous administration of anti-kistaminie drugs indicate that the hypotension observed following the rapid infusion of gelatine solutions is due to the release of histamine. Since histamine liberation has also been shown in preliminary studies in man, rapid infusions of gelatine solutions should be avoided in clinical practice, or patients receiving them should be pre-treated with anti-histaminic drugs.

Antibiotic prophylaxis influences cardiovascular stability in complicated surgery

“…Histamine release after haemorrhage has been demonstrated previously [28,29] but not with such a specific histamine assay [30]. Using specific assays, no change was observed after rapid bleeding in patients and in the experiments presented in this paper [31]. Thus the significant increase of plasma histamine concentrations following bleeding after co-amoxiclav premedication was even more surprising and provides further evidence for complex antibiotic interactions.…”

Histamine in Anaesthesia and Surgery: Causality Analysis

“…In addition it was demonstrated in a large series of experiments that not the rat (as happily believed by many pharmacologists until today), but the dog was the animal species which resembled the human individual in its reactions in clinically used plasma substitutes and made adverse reactions in patients in modified preparations or several batches of these drugs reasonably predictable (Fig. 3) (MESSMER et al 1970;LORENZ et al 1974cLORENZ et al ,d, 1978LORENZ et al , 1981b. Hence, also the nine Hill criteria for a causal association were fulfilled for polygeline in an analogy with propanidid.…”

“…This was later achieved in the same conditions in dogs by dimethindene (HI) + cimetidine (H2) (LORENZ and DOENICKE 1978a). (MESSMER et al 1970) Hence, again the Koch-Dale criteria and the Hill criteria have to be systematically applied in assessing adverse reactions to these two groups of substances. How necessary this was can be demonstrated by the letters to the Editor following the article of PHILBIN et al (1982a) in Anesthesiology: HIRSHMAN et al (1982) questioned the role of histamine in opioid hypotension; PHILBIN et al (1982b) andBEAVEN (1982) defended it using Koch-Dale criteria.…”

Elevated plasma histamine concentrations in surgery: Causes and clinical significance

“…Then methohexitone (2.5 mg/kg in 60 sec), propanidid (5 mg/kg in 20 sac), Althesin CT 1341@ (0.075 ml/kg in 60 sec), and Etomidate® (0.2 mg/kg in 20 sec) was injected and further blood samples were withdrawn at 1, 5, 10, 20 and 30 min following administration of the anaesthetic. in H e a l t h y T e s t Persons According to the technique of Messmer et al (1970), 500 ml of venous blood were obtained within about 3 rain (ca. 2 ml/kg and rain) using an equipment for blood donation.…”