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Adverse Reactions to Plasma Volume Expanders

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Summary

Plasma volume expanders are effective in the restoration of blood volume. All the available plasma volume expanders may rarely induce anaphylactoid reactions, although such reactions are extremely uncommon in shocked patients. The reactions are caused by different mechanisms depending on the solution, and there is little evidence that IgE antibodies are involved. In addition to these reactions, effects on haemostasis and renal function may occur, and the persistence of hydroxyethyl starch in the body has led to concern about its potential role as a carcinogen, although there is no evidence to suggest that this has occurred.

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References

  • Adlmann B, Schoning B. Binding of native and denatured collagen to immunoglobulins and cold insoluble globulin (CIG) in serum of patients undergoing orthopaedic surgery. Klinische Wochenschrift 58: 625–629, 1980

    Article  Google Scholar 

  • Alexander B. Effects of plasma expanders on coagulation and haemostasis: dextran, hydroxyethyl starch, and other macro-molecules revisited; blood colloids and plasma expanders. Progress in Clinical and Biological Research 19: 292–298, 1978

    Google Scholar 

  • Annest SJ, Scoulli WA, Blumenstock FA, Stratton HH, Newell JC, et al. Increased creatinine clearance following cryoprecipitate infusion in trauma and surgical patients with decreased renal function. Journal of Trauma 20: 726–730, 1980

    Article  PubMed  CAS  Google Scholar 

  • Bernstein RL, Rosenberg AD, Pada EY, Jaffe FF. A severe reaction to dextran despite hapten inhibition. Anaesthesiology 67: 567–569, 1987

    Article  CAS  Google Scholar 

  • Biro GP. Fluorocarbons in resuscitation of haemorrhage. International Anaesthesiology Clinics 23: 143–168, 1985

    Article  CAS  Google Scholar 

  • Bland JHL, Laver MB, Lowenstein E. Vasodilator effect of commercial 5% plasma protein solutions. Journal of the American Medical Association 224: 1721–1723, 1973

    Article  PubMed  CAS  Google Scholar 

  • Boon JC, Jesch F, Ring J, Messmer K. Long term intravascular persistence of hydroxyethyl starch (HES) in man. European Surgical Research 8: 497–503, 1976

    Article  PubMed  CAS  Google Scholar 

  • Claggett GP, Reisch JS. Prevention of venous thromboembolism in general surgical patients: results of meta-analysis. Annals of Surgery 208: 227–240, 1988

    Article  Google Scholar 

  • Coghill TH, Moore EE, Dunn EL, Cohen RG. Coagulation changes after albumin resuscitation. Critical Care Medicine 9: 22–26, 1981

    Article  Google Scholar 

  • Colman WR. Paradoxical hypotension after volume expansion with protein fractions. New England Journal of Medicine 229: 66–69, 1978

    Google Scholar 

  • Dahn MS, Lucas CE, Ledgerwood AM, Higgins RF. Negative inotropic effect of albumin resuscitation for shock. Surgery 86: 235–239, 1979

    PubMed  CAS  Google Scholar 

  • Elliott LA, Legerwood AM, Lucas CM, et al. Role of Fluosol DA 20% in prehospital resuscitation. Critical Care Medicine 17: 166–172, 1989

    Article  PubMed  CAS  Google Scholar 

  • Engberg A. Effects of dextran 40 on the proximal renal tubule. Acta Chirurgica Scandinavica 142: 172–175, 1976

    PubMed  CAS  Google Scholar 

  • Fisher MM. Anaphylaxis. Disease a Month 33: 435–479, 1987

    Article  Google Scholar 

  • Fisher MM. Direct histamine release in anaesthesia and surgery: unanswered questions. Theoretical Surgery 3: 145–147, 1988

    Google Scholar 

  • Hedin H, Richter W, Ring J. Dextran-induced anaphylactoid reactions in man: role of dextran reactive antibodies. Internal Archives of Allergy and Applied Immunology 52: 145–159, 1976

    Article  CAS  Google Scholar 

  • Hossaini AA, Wasserman JJ, Venart GP. Experimental induction of caprylate dependent albumin antibodies. American Journal of Clinical Pathology 65: 513–516, 1975

    Google Scholar 

  • Isbister JP, Biggs JC. Reaction to rapid infusion of soluble plasma protein solution during large volume plasma exchange. Anaesthesia and Intensive Care 4: 105–109, 1976

    PubMed  CAS  Google Scholar 

  • Isbister JP, Fisher MM. Adverse effects of plasma volume expanders. Anaesthesia and Intensive Care 8: 145–151, 1980

    PubMed  CAS  Google Scholar 

  • Johnson SD, Lucas CE, Gerrick SJ, Ledgerwood AM, Higgins RF. Altered coagulation after albumin supplements for treatment of oligemic shock. Archives of Surgery 114: 379–383, 1979

    Article  PubMed  CAS  Google Scholar 

  • Klein RE, Kogollon G. Erythema multiforme following the infusion of hydroxyethyl starch. Transfusion 68: 166–167, 1984

    Article  Google Scholar 

  • Kohler H, Kirch W, Horstman HJ. Hydroxyethyl starch-induced macroamylasemia. International Journal of Clinical Pharmacology and Biopharmacy 15: 428–429, 1977

    PubMed  CAS  Google Scholar 

  • Kovalik SG, Ledgerwood AM, Lucas CE, Higgins RF. The cardiac effect of altered calcium haemostasis after albumin resuscitation. Journal of Trauma 21(4): 275–279, 1981

    Article  PubMed  CAS  Google Scholar 

  • Kraft D, Hedin H, Richter W, Scheiner O, Rumpold H, et al. Immunoglobulin class and subclass distribution of dextran-reactive antibodies in human reactors and non reactors to clinical dextran. Allergy 37: 481–489, 1982

    Article  PubMed  CAS  Google Scholar 

  • Lockwood DNJ, Bullen C, Machin SJ. A severe coagulopathy following volume replacement with hydroxyethyl starch in a Jehovah’s Witness. Anaesthesia 43: 391–393, 1988

    Article  PubMed  CAS  Google Scholar 

  • Lorenz W, Doenicke A, Schoning B, Karges H, Schmal A. Incidence and mechanisms of adverse reactions to polypeptides in man and dog. In Joint WHO/IABS Symposium of the Standardization of Albumin, Plasma Substitutes, and Plasmaphoresis, Geneva 1980, Development Biological Standard 48, S. Karger Basel, pp. 207–234, 1981

  • Lucas CE, Denis R, Legerwood AM, Grabow D. The effects of hespan on serum and lymphatic albumin, globulin and coagulant protein. Annals of Surgery 207: 416–420, 1988

    Article  PubMed  CAS  Google Scholar 

  • Messmer K, Ljunstrom K-G, Gruber U-F, Richter W, Hedin H. Prevention of dextran-induced anaphylactoid reactions by hapten inhibition. Lancet 1: 975–977, 1980

    Article  PubMed  CAS  Google Scholar 

  • Mitsuno T, Ohyanagi H, Naito R. Clinical studies of a perfluorochemical whole blood substitute (Fluosol DA). Annals of Surgery 195: 60–69, 1982

    Article  PubMed  CAS  Google Scholar 

  • Paull J. A prospective study of dextran-induced anaphylactoid reactions in 5745 patients. Anaesthesia and Intensive Care 15: 163–167, 1987

    PubMed  CAS  Google Scholar 

  • Rajagopalan PR, Reines HD, Pulliam C, Fitts CT, LeVeen HH. Reversal of acute renal failure using haemodilution with hydroxyethyl starch. Journal of Trauma 23: 795–800, 1983

    Article  PubMed  CAS  Google Scholar 

  • Raper RF, Fisher MM. Resuscitation in acute haemorrhage. Anaesthesia and Intensive Care 12: 212–216, 1984

    PubMed  CAS  Google Scholar 

  • Renck H, Ljungstrom K-G, Hedin H, Richter W. Prevention of dextran-induced anaphylactic reactions by hapten inhibition. Acta Chirurgica Scandanavica 149: 355–360, 1983

    CAS  Google Scholar 

  • Ring J. Colloids. Clinics in Anaesthesiology 2: 619–641, 1984

    Google Scholar 

  • Ring J, Messmer K. Incidence and severity of anaphylactoid reactions to colloid volume substitutes. Lancet 1: 466–469, 1977

    Article  PubMed  CAS  Google Scholar 

  • Ring J, Stephan W, Brendel W. Anaphylactoid reactions to infusion of plasma protein and human serum albumin. Clinical Allergy 9: 89–99, 1979

    Article  PubMed  CAS  Google Scholar 

  • Schwarz J, Ihle B, Dowling J. Acute renal failure induced by low molecular weight dextran. Australian and New Zealand Journal of Medicine 14: 688–690, 1984

    Article  PubMed  CAS  Google Scholar 

  • Torda TA, Harrisson GA, McCulloch CH, Wright JS, Stacey R, et al. Circulatory effects of stable plasma protein solution (SPPS). Medical Journal of Australia 1: 798–800, 1973

    PubMed  CAS  Google Scholar 

  • Tremper KK, Lapin R, Levine E, et al. Haemodynamic and oxygen transport effects of a perfluorochemical blood substitute. Critical Care Medicine 8: 738–741, 1980

    Article  PubMed  CAS  Google Scholar 

  • Vercellotti G, Hammerschmidt BE, Craddock P. Activation of plasma complement by perfluorocarbon: possible mechanism of adverse pulmonary reactions in treated patients. Blood 59: 1299–1304, 1982

    PubMed  CAS  Google Scholar 

  • Vervloet D, Senft M, Dugue P, Arnaud A, Charpin J. Anaphylactic reactions to modified gelatins. Journal of Allergy and Clinical Immunology 71: 535–540, 1983

    Article  PubMed  CAS  Google Scholar 

  • Ziegler HK. Sektionstefund bei Dextranzwischenfall. Medizinische Klinik 73: 1089–1090, 1978

    PubMed  CAS  Google Scholar 

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Fisher, M.M., Brady, P.W. Adverse Reactions to Plasma Volume Expanders. Drug-Safety 5, 86–93 (1990). https://doi.org/10.2165/00002018-199005020-00002

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