Anaphylaxis to colloids

The risks associated with blood transfusions and the shortage of available blood have led to increased administration of substitute solutions for volume expansion. Colloids are commonly used and three of the main colloids commonly administered, gelatin, hydroxyethyl starch, and dextran will be discussed. Each one may cause adverse reactions ranging from grade I with skin manifestations to grade IV involving cardiac and/ or respiratory arrest. 

Hydroxyethyl starch (HES), also known as hetas-tarch, is most often administered for intravascular volume expansion during the perioperative period and for resuscitation from trauma and shock. Because of its property of increasing blood fluidity, hydroxyethyl starch is sometimes infused to treat patients with disturbed microcirculation. 

For skin testing, solutions are used undiluted for the prick test and at a dilution of from 1 in 100 to undiluted for intradermal testing. 

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