A prospective study of dextran-induced anaphylactoid reactions (DIAR) in 5745 gynaecological and obstetric patients who received dextran 70 solution intravenously while undergoing major surgery revealed 8 patients who had Grade I or II reactions and 7 patients who had Grade III or IV reactions. The incidence of severe reactions was 1:821 patients treated. The overall incidence of reactions per patient treated was 1:383. One neonatal death followed a dextran-induced cardiac arrest in a woman about to undergo caesarean section. The risks of dextran 70 treatment exceeded the risks of thromboembolism in these patients.
ThorsenG.The use of dextrans as infusion fluids. Surg Gynaecol Obstet1959; 109:43–47.
2.
KabatEA, TurinoGM, TarrowAB, MaurerPH. Studies on the immunological basis of allergic reactions to dextran in man. J Clin Invest1957; 36:1160–1164.
3.
GruberUF. Blood Replacement. Springer, Berlin1969; p. 57.
4.
RingJ.Anaphylaktoide Reaktionen nach Infusion Naturlicher und kunstlicher Kolloide. Springer, Berlin1978. Cited in RingJ.Anaphylactoid reactions to plasma substitutes. Int Anesthesiol Clin1985; 23(3):69.
5.
CrandonAJ, KouttsJ.Incidence of post-operative deep vein thrombosis in gynaecological oncology. Aust NZ J Obstet Gynaec1983; 23:216–219.
6.
RingJ, MessmerK.Incidence and severity of anaphylactoid reactions to colloid volume substitutes. Lancet1977; 1:466–469.
7.
RingJ.Anaphylactoid reactions to plasma substitutes. Int Anaesthesiol Clin1985; 23(3):71.
8.
FisherMM. Intradermal testing in the diagnosis of acute anaphylaxis during anaesthesia — results of five years experience. Anaesth Intens Care1979; 7:58–61.
PaullJD (ed.). Second Report of the Victorian Consultative Council on Anaesthetic Mortality and Morbidity 1983–84. Health Commission of Victoria, Melbourne1985; pp. 11, 19.
11.
RingJ.Anaphylactoid reactions to plasma substitutes. Int Anesthesiol Clin1985; 23(3):67–95.
12.
ClaytonJK, AndersonJA, McNicolGP. Preoperative prediction of post-operative deep vein thrombosis. Br Med J1976; 2:910–912.
13.
CrandonAJ, PeelKR, AndersonJA, ThompsonV, McNicolGP. Post-operative deep vein thrombosis: Identifying high risk patients. Br Med J1980; 281:343–344.
14.
Consultative council on maternal and perinatal mortality.Survey of perinatal deaths and report on maternal deaths in Victoria. 1980; 29–30.
15.
Consultative council on maternal and perinatal mortality.Survey of perinatal deaths and report on maternal deaths in Victoria. 1981; 32–33.
16.
Consultative council on maternal and perinatal mortality and morbidity.Survey of perinatal deaths in Victoria1982; 33–34.
17.
Consultative council on maternal and perinatal mortality and morbidity.Survey of perinatal deaths in Victoria1983; 34–35.
18.
Consultative council on maternal and perinatal mortality and morbidity.Survey of perinatal deaths in Victoria1984; 34–35.
19.
Consultative council on obstetric and paediatric mortality and morbidity.Annual report for the year1985; 24–26.
20.
BjorksteinB, HatterigG, KjellmanB, AhlstedtS, RichterW.Dextran-reactive antibodies in healthy infants and toddlers: relation to type of feeding. Int Arch Allergy Appl Immunol1982; 69:1974–1978.
21.
HedinH, RichterW, MessmerK, RenckH, LjungstromKG, LaubenthalH.Incidence, pathomechanisms of dextran-induced anaphylactoid/ anaphylactic reactions in man. Dev Biol Stand1981; 48:179–181.
22.
HedinH, RichterW.Pathomechanisms of dextran-induced anaphylactoid/anaphylactic reactions in man. Int Arch Allergy Appl Immunol1982; 68:122–126.
23.
HedinH, RichterW, RingJ.Dextran-induced anaphylactoid reactions in man: role of dextran reactive antibodies. Int Arch Allergy Appl Immunol1976; 52:145–159.
24.
LjungstromKG. Prophylaxis of postoperative thromboembolism with dextran 70: improvements of efficacy and safety. Stockholm: Akademisk Avhandling Karolinska Institute1983; pp. 1–96. Cited in RingJ.Anaphylactoid reactions to plasma substitutes. Int Anesthesiol Clin1985; 23(3):80.