By Jerrold H. Levy
This booklet offers anaesthetists with a pragmatic method of the popularity, realizing, and administration of life-threatening reactions to anaesthesia and different medications used in the course of surgical procedure and within the ICU
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Extra resources for Anaphylactic Reactions in Anesthesia and Intensive Care
Histamine-induced coronary vascular changes persisted after H 2 receptor blockade. , 1 9 8 7 ) . , 1 9 8 6 ) . Selective H a receptor stimulation was achieved by infusing 0 . 5 |xg/kg/min o f histamine intravenously for 5 minutes after pretreatment with the H 2 receptor antagonist cimetidine at a massive dose o f 2 5 mg/kg. H e a r t rate was maintained constant by coronary sinus pacing. In patients with normal coronary arteries, mean arterial pressure fell from 9 9 ± 5 to 7 7 ± 4 m m H g . 07 ± 0 .
1 9 8 0 ) . H u m a n lung contains macrophages and endothelial cells in addition to mast cells, which may account for the t h r o m b o x a n e A 2 release. Prostaglandin D2 M a s t cells are the m a j o r source o f prostaglandin D 2 (Wasserman, 1 9 8 3 a ) . Prostaglandin D 2 increases nondirected migration o f polym o r p h o n u c l e a r leukocytes and inhibits enzyme release induced by other agents. , 1 9 8 4 ) . In the vasculature, prostaglandin D 2 produces slight enhancement o f microvascular permeability and systemic vasodilation.
1 9 8 3 ) . Purified h u m a n prekallikrein was converted t o the active form (kallikrein) by the lung protease. T h e kallikrein produced was shown to generate bradykinin from purified h u m a n high-molecular-weight kininogen. T h e prekallikrein activator provides a physiologic mechanism by which kallikrein can be formed during anaphylaxis in humans. Several processes independent o f IgE can also generate kinins. T h e s e are discussed in Chapter 4 . Kinins circulate in plasma as precursors that include a high-molecularweight kininogen ( 1 1 0 , 0 0 0 d) and a low-molecular-weight kininogen ( 7 0 , 0 0 0 daltons).
Anaphylactic Reactions in Anesthesia and Intensive Care by Jerrold H. Levy