Anaesthesia and intensive care
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A thirty-year-old female presented with a high fever, conjunctivitis, confusion, vomiting, watery diarrhoea, diffuse erythroderma, shock and oliguric renal failure. Staphylococcus aureus phage 29/52 (Group 1) was isolated from a high vaginal swab. In addition to all the previously reported features which defined toxic shock syndrome, there were pustular skin vesicles, altered red cell morphology, and severe myocardial involvement. Treatment with fluid replacement, cloxacillin, haemodialysis, positive inotropic agents, and supportive measures resulted in a full recovery.
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Anaesth Intensive Care · Nov 1981
Intradermal drug testing following anaphylactoid reactions during anaesthesia.
Intradermal testing of intravenous anaesthetic drugs was performed on 34 patients following acute anaphylactoid reactions during anaesthesia. Twenty-three patients had positive skin tests and 18 of these were positive for a single drug. Muscle relaxants were the drugs implicated most commonly. Intradermal testing is safe and provides useful and often specific positive information, but false-negative results probably occur.
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Anaesth Intensive Care · Nov 1981
Letter Case ReportsVentilator malfunction detected by O2 analyser.
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Anaesth Intensive Care · Aug 1981
The epidemiology and clinical features of anaphylactic reactions in anaesthesia.
Severe anaphylactoid reactions during anaesthesia in 116 patients are described. The majority of patients who reacted to induction agents had previous exposure to the drug, while the majority of patients who reacted to muscle relaxants had not. There was a statistically significant increased incidence of allergy, atopy, asthma and previous reactions in patients who had reactions compared with a control group undergoing uneventful anaesthesia. ⋯ No one drug produced reactions that differed in severity or clinical features from any other drug. Clinical features included skin changes, oedema, cardiovascular collapse, bronchospasm, gastrointestinal symptoms, prolonged unconsciousness, convulsions and pulmonary oedema. Four patients died.
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Anaesth Intensive Care · Aug 1981
The diagnosis of acute anaphylactoid reactions to anaesthetic drugs.
Patients with a presumptive diagnosis of an acute anaphylactoid reaction to anaesthesia were investigated to determine the cause of the reaction and the drug responsible by intradermal testing, patch and prick testing, sequential complement measurement, passive transfer testing and challenge. The most valuable information was provided by intradermal testing and a diagnosis could be made in 150 of 165 patients. When analphylactoid reactions to anaesthetic drugs occur, intradermal testing one month after the reaction and sequential complement measurements in the immediate post reaction period will enable the diagnosis to be established in the majority of cases. Intradermal testing is of no value for trivial reactions or reactions to colloid solutions or contrast media.