Elevated plasma histamine concentrations in surgery: Causes and clinical significance

Abstract

Summary. Histamine concentrations in plasma, whole blood and various tissues of human subjects, monkeys, pigs and dogs were determined by fluorometric methods before, during and after surgical operations. Following intraabdominM surgery in 6 of 22 patients elevated plasma histamine levels were found several hours after the end of operation. Some of the causes of histamine release in surgery were found to be premeditation by atropine, intravenously administered anaesthetics, infusion of plasma substitutes and manipulation on the gut. Acute blood losses were without effect on the plasma histamine levels. Clinical symptoms and pathophysiological reactions, such as taehyeardia, hypotension, increased gastric secretion and anaphylactoid reactions could be related to the release of histamine in some circumstances.

Plasma histamine levels in patients in the course of several standard operations: Influence of anaesthesia, surgical trauma and blood transfusion

“…Histamine release in surgery by surgical trauma or injury is a problem which has really interested several generations of surgeons and specialists in many medical disciplines (Schneider 1930;Minard 1937;Dragstedt and Mead 1937;Mac Donald and Woolfe 1938;Rose and Browne 1940;Koslowski et al 1982;Spuzic and Halpern 1959;Rosenthal 1969;Berg et al 1971;Lorenz et al 1973;Lorenz et al 1974 Thermann et al 1978). Findings and hypothe-ses sometimes were in favour of a role of histamine in this stressful condition, sometimes against it, but without any exception all authors agree that this role has yet to be defined.…”

“…1972) which could successfully be used to determine histamine release and its significance linked to clinical conditions. Thus, several groups have investigated changes of plasma histamine concentrations and their biological influence in renal and liver transplantation (Thermann et al 1978;Lorenz et al 1973), in abdominal surgery (Lorenz et al 1974, Beger et al, 1975 and in severe polytrauma (Fischer et al 1978). More than in surgery, however, the role of increased histamine release is documented by now in anaphylactoid reactions to various drugs applied in the course of anaesthesia .…”

Histamine and stress ulcer: New components in organizing a sequential trial on cimetidine prophylaxis in seriously Ill patients and definition of a special group at risk (severe polytrauma)

“…February 1976: Continuing previous studies on histamine and stress ulcers [59,61] the first setting of a double-blind randomized controlled trial was produced on cimetidine prophylaxis in patients of the intensive care unit.…”

“…The time intervals were chosen since at the first day elevated plasma histamine levels were expected as a consequence of trauma, shock, operations, infusions etc. [61,62]. The highest incidence of clinically manifest ulcerations was usually observed around the fifth day after the accident and the histamine level at the fourteenth day was considered as a reasonable control value which could be obtained without too many difficulties.…”

“…The highest incidence of clinically manifest ulcerations was usually observed around the fifth day after the accident and the histamine level at the fourteenth day was considered as a reasonable control value which could be obtained without too many difficulties. Since only very small alterations of the plasnaa histamine concentrations were expected to be measured [61,62], a more sensitive assay than at present available [60] had to be developed. There are only preliminary reports on this assay till now [66,67], but it will be published in all details in this [3] series of communications.…”