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Slowing of the heart during anaphylactic shock
Author(s) -
Secher N. H.
Publication year - 1988
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1988.tb02754.x
Subject(s) - medicine , shock (circulatory) , anesthesia , heart rate , anaphylactic shock , blood pressure , central venous pressure , anaphylaxis , arterial oxygen tension , mean arterial pressure , cardiology , allergy , lung , immunology
Five patients are reported with anaphylactic shock reactions due to i.v. administration of atracurium, methicillin, amidotrezoate (n = 2) and plasma. In these patients a fall in heart rate (HR) from 5–50 beats min ‐1 was recorded during the hypotensive period. In three of the patients HR was 40 beats min ‐1 or less, and in two of the patients a hypotensive bradycardiac episode spontaneously reappeared after normal HR and BP were established. Central venous pressure (CVP) fell in one patient from 0.8 to 0.6 kPa as HR and BP decreased while arterial oxygen tension remained normal. All patients were in a stable condition after treatment with volume expansion and sympathomimetic drugs. These observations indicate that anaphylactic shock is associated with a strong and sometimes persistent vagal tone to the heart in parallel with the early reaction to hypotensive hypovolaemic shock.