Abstract
The effects of cremophor EL were studied in 13 anaesthetized, paralyzed and ventilated dogs. Twenty per cent cremophor EL in a dose of 4.3 ± 0.92 ml was infused at a rate of 30 ml · hr-1. In seven dogs, thoracopulmonary compliance, heart rate, systemic arterial pressure (SAP), pulmonary pressures (PAP, PCWP, RAP), cardiac output (CO) and platelet and white cell counts, were measured before the injection of cremophor EL, at the end of infusion and 5,10, 30 and 150 minutes after the end of infusion. In six dogs, SAP, CO, and blood volume were measured before the injection of cremophor EL, at the end of infusion and 10, 30, 90 and 150 minutes after the end of infusion. Plasma histamine and catecholamines were assayed before the injection of cremophor EL and 2, 5, 10, 30, 90 and 150 minutes after starting the infusion.
Cremophor EL induced a marked, sustained and significant decrease in SAP at the end of infusion and at 5, 10 and 30 minutes after the completion of the infusion (-68, -71, -70 and -43 per cent respectively), in PCWP, RAP and CO (-78 per cent at the end of infusion, -32 per cent 150 minutes after the end of infusion). Heart rate and systemic vascular resistance did not vary significantly. Pulmonary vascular resistance increased at the end of infusion, five and ten minutes after the end of infusion ( + 734, +548 and +439 per cent respectively). Plasma volume decreased 10 and 30 minutes after the end of infusion (-28 and -30.5 per cent respectively). Thoracopulmonary compliance decreased (-46 per cent at the end of infusion). Platelet and white cell counts decreased markedly. There was a marked and sustained increase in plasma hista mine (+ 1214 per cent 10 minutes after start of infusion) and in plasma epinephrine and norepinephrine. In six dogs cutaneous erythema and oedema of the paws and of the muzzle were present.
These findings are very similar to the observations reported in man during anaphylactoid and/or anaphylactic reactions. This model could be used in studying anaphylactoid reactions and their prevention and treatment.
Résumé
Les effets du crémophor EL ont été étudiés chez 13 chiens anesthésiés, curarisés et ventilés artificiellement. 4.3 ± 0.92 ml de crémophor à 20 pour cent ont été injectés à la vitesse de 30 ml/heure. Chez sept chiens, la compliance thoracopulmonaire, la fréquence cardiaque, la pression artérielle sy stérnique (SAP), les pression pulmonaires (PAP, PCWP, RAP), le débit cardiaque (CO), les plaquettes et les leucocytes, ont été mesurés avant ľinjection de crémophor EL, à la fin de ľinjection et 5,10, 30 et 50 minutes après la fin de ľinjection. Chez six chiens, SAP, CO et la masse sanguine ont été mesurés avant ľinjection de crémophor EL et 10, 30, 90 et 150 minutes après la fin de ľinjection. Ľhistamine et les catécholamines plasmatiques furent mesurées avant ľinjection de crémophor EL et 2, 5, 10, 30, 90 et 150 minutes après le début de ľinjection.
Le crémophor EL provoqua une diminuton importante, durable et significative de SAP à la fin de ľinjection, 5, 10 et 30 minutes après la fin de ľinjection (respectivement, -68, -71,-70 et -43 pour cent), de PCWP, de RAP et de CO (-78 pour cent à la fin de ľinjection, -32 pour cent 150 minutes après la fin de ľinjection). La fréquence cardiaque et les résistances vasculaires systémiques ne varièrent pas significativement. Les résistances vasculaires pulmonaires augmentèrent à la fin de ľinjection, cinq et dix minutes après la fin de ľinjection (respectivement +734, +548 et +439 pour cent). Le volume plasmatique diminua 10 et 30 minutes après la fin de ľinjection (respectivement -28 et -30.5 pour cent). La compliance thoracopulmonaire diminua (-46 pour cent à la fin de ľinjection). Les plaquettes et les leucocytes diminuèrent fortement. Il y eut une augmentation très importante et durable de V histamine plasmatique (+1214 pour cent dix minutes après te début de ľinjection) et des catécholamines plasmatiques. Chez six chiens un érythème cutané et un œdème des pattes et du museau furent observés.
Ces effets sont très proches des phénomènes rapportés chez ľhomme au cours ďaccidents anaphylactiques etlou anaphylactoids. Ce modèle pourrait être utilisé pour ľétude des réactions anaphylactoides, de leur prévention et de leur traitement.
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Gaudy, J.H., Sicard, J.F., Lhoste, F. et al. The effects of cremophor EL in the anaesthetized dog. Can J Anesth 34, 122–129 (1987). https://doi.org/10.1007/BF03015328
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DOI: https://doi.org/10.1007/BF03015328