Article

Blood transfusion-induced anaphylaxis and coronary artery spasm during general anesthesia.

Department of Anesthesiology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Japan.
Journal of Anesthesia (impact factor: 0.83). 02/2008; 22(4):457-9. DOI:10.1007/s00540-008-0658-7 pp.457-9
Source: PubMed

ABSTRACT Anaphylactic reactions to blood transfusion can lead to life-threatening cardiovascular disruptions. We describe a case in which anaphylaxis due to blood transfusion during general anesthesia was the probable cause of coronary artery spasm. Thirty minutes after the transfusion of concentrated red blood cells, the patient's blood pressure had dropped to 70/40 mmHg and peak airway pressure had increased to 35 cmH2O. The ST segment of the ECG was simultaneously elevated, and the left upper arm became extensively flushed. The tryptase concentration in the patient's plasma collected 3 h postoperatively was 13.9 microg x l(-1) (normal range, 2.1-9.0 microg x l(-1)). This case report emphasizes that anaphylactic reactions to blood transfusion can potentially lead to coronary artery spasm.

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Keywords

3 h postoperatively
 
anaphylactic reactions
 
anaphylaxis
 
blood transfusion
 
case report emphasizes
 
concentrated red blood cells
 
coronary artery spasm
 
ECG
 
general anesthesia
 
left upper arm
 
patient's blood pressure
 
peak airway pressure
 
probable cause
 
ST segment
 
tryptase concentration