English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

A 61 year old male patient undergoing gastrectomy under general anesthesia developed severe anaphylactoid shock after 15 minutes from starting 5% albumin infusion. His blood pressure went from 101/67 down to 44/23 with his heart rate going up from 91 to 99. A total of 1600 mcg of phenylephrine were given without any improvement in the hemo-dynamics. We then gave 50 mcg of Epinephrine to which blood pressure rapidly responded going up to 141/60 (mean 88). Then 15 mg of Dexamethasone were given. Blood pressure remained stable with the mean between 75 and 90, without requiring anymore pressors. 5% albumin is considered among the safer colloids with a risk of anaphylactoid reactions less than gelatins and dextrans and comparable to starches. However, severe life threatening anaphylaxis has been reported with Albumin infusion. With the still ongoing crystalloid colloid debate, with many studies showing no survival benefit with colloid use for volume resuscitation, the risk of severe anaphylactic shock, even with the safer colloids like albumin should drive to a more conservative use of albumin for volume resuscitation, specially under general anesthesia, when recognizing the signs and symptoms of anaphylaxis and the offending agent maybe more challenging.

Anaphylactoid Shock with Infusion of 5% Albumin in a Patient under General Anesthesia