Cardiac output during an anaphylactoid reaction

Abstract

Cardiac output during an anaphylactoid reaction Cardiac output has only rarely been measured during an anaphylactoid reaction in man because of the nature of the condition. We report here its measurement using oesophageal Doppler ultrasound.was with intravenous infusions of alfentanil (40 mg/ hour for 5 minutes then 4 mg/hour) and methohexitonc (100 mg bolus then 500 mg/hour). Neuromuscular blockade was obtained with a bolus of alcuronium 20 A 15-year-old boy who weighed 65 kg presented for craniotomy to excise a large cystic lesion in the parietal region. He had been otherwise healthy apart from recent onset of epilepsy. He had undergone an uneventful anaesthetic for dental surgery as a young child and gave no history of atopy or previous drug reactions though, on questioning his mother after the event, it was discovered that he had suffered intermittently from eczema throughout his childhood. His drug therapy consisted of phenytoin 100 mg tds, carbamazepine 200 mg intravenously. The lungs were ventilated with 100% oxygen throughout the procedure. A tracheal tube was inserted and a Doppler ultrasound probe passed into the oesophagus. The patient was normotensive and the lungs were easily ventilated during the induction period.The lungs became difficult to ventilate about 10 minutes after induction and a widespread urticaria1 rash developed. Widespread rhonchi were heard on auscultation of the chest. The infusions were stopped mg bd and dexamethasone 4 mg qid orally.Premedication was with diazepam 10 mg orally given about one hour before induction of anaesthesia, which and anaesthesia maintained with halothane 0.5%. An intravenous bolus of chlorpheniramine 10 mg was given. The blood was found to be frankly cyanotic

Anaphylactoid or Carcinoid?

“…As there was no bronchospasm and cardiac output during acute anaphylaxis has been shown to increase [15], a directly acting alpha agonist was felt most appropriate, and methoxamine was prepared.…”