Notes on Desensitisation of a Patient Hypersensitive to Bee Stings

Браун,

doi:10.1080/0005772x.1926.11096103

Cited by 11 publications

(11 citation statements)

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“…However, part of the differences we observed could also be related to the reduction of adrenaline doses when the primary MAP target was reached. Adrenaline has been considered useful in the treatment of anaphylactic shock since as early as 1925 23 and retrospective analyses have indicated that adrenaline and volume expansion are effective treatments for anaphylaxis occurring under anaesthesia [24][25][26] . A relatively high dose of adrenaline was chosen for bolus administration in this study.…”

Section: Discussionmentioning

confidence: 99%

Time to Achieve Target Mean Arterial Pressure during Resuscitation from Experimental Anaphylactic Shock in an Animal Model. A Comparison of Adrenaline Alone or in Combination with Different Volume Expanders

Tajima

Zheng

Collange

et al. 2013

Anaesth Intensive Care

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Anaphylactic shock is a rare, but potentially lethal complication, combining life-threatening circulatory failure and massive fluid shifts. Treatment guidelines rely on adrenaline and volume expansion by intravenous fluids, but there is no solid evidence for the choice of one specific type of fluid over another. Our purpose was to compare the time to achieve target mean arterial pressure upon resuscitation using adrenaline alone versus adrenaline with different resuscitation fluids in an animal model and to compare the tissue oxygen pressures (PtiO 2) with the various strategies. Twenty-five ovalbumin-sensitised Brown Norway rats were allocated to five groups after anaphylactic shock induction: vehicle (CON), adrenaline alone (AD), or adrenaline with isotonic saline (AD+IS), hydroxyethyl starch (AD+HES) or hypertonic saline (AD+HS). Time to reach a target mean arterial pressure value of 75 mmHg, cardiac output, skeletal muscle PtiO 2 , lactate/pyruvate ratio and cumulative doses of adrenaline were recorded. Non-treated rats died within 15 minutes. The target mean arterial pressure value was reached faster with AD+HES (median: 10 minutes, range: 7.5 to 12.5 minutes) and AD+IS (median: 17.5 minutes, range: 5 to 25 minutes) versus adrenaline alone (median: 25 minutes, range: 20-30 minutes). There were also reduced adrenaline requirements in these groups. The skeletal muscle PtiO 2 was restored only in the AD+HES group. Although direct extrapolation to humans should be made with caution, our results support the combined use of adrenaline and volume expansion for resuscitation from anaphylactic shock. When used with adrenaline the most effective fluid was hydroxyethyl starch, whereas hypertonic saline was the least effective.

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Section: Discussionmentioning

confidence: 99%

Time to Achieve Target Mean Arterial Pressure during Resuscitation from Experimental Anaphylactic Shock in an Animal Model. A Comparison of Adrenaline Alone or in Combination with Different Volume Expanders

Tajima

Zheng

Collange

et al. 2013

Anaesth Intensive Care

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“…Epinephrine (adrenaline) has been considered useful in the treatment of anaphylactic shock since as early as 1925 [23] and retrospective analyses have indicated that epinephrine and fluid resuscitation are effective treatments for anaphylaxis occurring under anaesthesia [5,24]. However, the benefits of intravenous boluses of epinephrine can be marginal and short-lived, leading to concerns as to the efficacy of this treatment in severe reactions [10].…”

Section: Epinephrine Intravenous Fluids and Peripheral Vasoconstrictorsmentioning

confidence: 98%

Cardiovascular aspects of anaphylaxis: implications for treatment and diagnosis

Brown

2005

Current Opinion in Allergy &Amp; Clinical Immunology

148

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“…The earliest report of immunotherapy for bee sting anaphylaxis was by Braun in 1925, who used an extract of the parts of the bodies of bees containing the venom sacs [1]. Many thousands of people were subsequently treated with extracts of whole bodies of insects.…”

Section: Introductionmentioning

confidence: 99%

The incidence and nature of adverse reactions to injection immunotherapy in bee and wasp venom allergy

Youlten

Atkinson

Lee

1995

Clin Experimental Allergy

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The incidence, time course and nature of systemic reactions to injections of bee and wasp venom during immunotherapy have been estimated in an open, prospective, single centre study. One hundred and nine survivors of moderate to severe systemic reactions to stings from hymenoptera, received courses of bee or wasp venom by monthly subcutaneous injection for up to 3 years. Systemic reactions were recorded after 7.5% of 946 weekly venom injections during the initial phase of treatment, and after 2.1% of 1789 monthly maintenance injections. In both phases of treatment, reactions were more frequent after bee (17% of initial phase, 7.8% of maintenance treatment) than after wasp (3% of initial phase, 0.3% of maintenance treatment) venom injections. The percentage of patients experiencing at least one reaction was also higher for bee (46%) than for wasp (14%) sensitive patients. Over 80% of reactions began within 30 min of injection, over 90% within 1 h and only two (2%), between 1 and 2 h, the remaining six (5.5%) starting more than 2 h after injection. Only 0.47% of venom injections produced a systemic reaction which was severe enough to require adrenaline treatment. The female patients experienced more reactions (21% of the wasp, 60% of the bee, sensitive) than the males (5.5% wasp, 20% bee). Age and atopy did not appear to be significant risk factors for systemic reactions. We conclude that wasp and bee venom immunotherapy in a conventional dosage regimen was generally well tolerated.(ABSTRACT TRUNCATED AT 250 WORDS)

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Notes on Desensitisation of a Patient Hypersensitive to Bee Stings

Cited by 11 publications

References 0 publications

Time to Achieve Target Mean Arterial Pressure during Resuscitation from Experimental Anaphylactic Shock in an Animal Model. A Comparison of Adrenaline Alone or in Combination with Different Volume Expanders

Time to Achieve Target Mean Arterial Pressure during Resuscitation from Experimental Anaphylactic Shock in an Animal Model. A Comparison of Adrenaline Alone or in Combination with Different Volume Expanders

Cardiovascular aspects of anaphylaxis: implications for treatment and diagnosis

The incidence and nature of adverse reactions to injection immunotherapy in bee and wasp venom allergy

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