Gelofusine Adverse Reactions

After the administration of Gelofusine infusions, just as of any colloidal volume substitutes, anaphylactoid or anaphylactic reactions of varying degrees of severity may occur. These reactions manifest as fever or cutaneous eruptions (urticaria) or sudden flushing of the face and neck. In rare cases, they may proceed over sudden flushing of the face and neck to drop in blood pressure, shock, cardiac and respiratory arrest.
Severe anaphylactoid reactions (grade III or IV) are rare with an incidence of about 1 : 13 000. Patients receiving Gelofusine must be continuously observed for the occurrence of anaphylactoid or anaphylactic reactions.
General guidelines for the prophylaxis of adverse reactions: Adequate information of physicians and nursing staff about the type and severity of possible adverse reactions that may be encountered after the administration of a colloidal volume substitute.
Close observation of the patient during infusion, especially while the first 20 - 30 ml of the solution are being infused.
Availability of all apparatus and medication required for resuscitation.
Stop of infusion immediately, as soon as there are any indications of adverse reactions.
It cannot be predicted by any test procedure which patients are likely to experience anaphylactic or anaphylactoid reactions, nor is it possible to foresee the course and severity of any such reaction. Anaphylactic or anaphylactoid reactions caused by gelatine solutions may either be histamine-mediated or histamine independent. Histamine release can be prevented by the use of a combination of H₁- and H₂-receptor blockers. Prophylactic administration of corticosteroids has not proved effective.
Adverse reactions may occur in conscious and anaesthetized patients. In the acute phase of volume deficiency shocks, so far no anaphylactic or anaphylactoid reaction has ever been reported. (See table.)

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