General Approach to the Patient in Anaphylaxis

Yıl 2022, Cilt: 17 Sayı: 3, 228 - 234, 02.11.2022

Aykut Urfalıoğlu

https://doi.org/10.17517/ksutfd.1086290

Öz

Abstract

Anaphylaxis is a life-threatening hypersensitivity reaction that can develop as a result of contact with any allergen. A rapid worsening and cardiopulmonary arrest may occur after symptoms appear, depending on the type and duration of exposure to the allergen. Early recognition of clinical signs and symptoms of anaphylaxis and prompt initiation of emergency treatment may reduce mortality. This review is designed to raise awareness of all healthcare practitioners about the general characteristics, treatment and patient management of anaphylaxis. Regarding the subject, it is aimed to provide the latest information by scanning the current algorithms of anaphylaxis and advanced life support in anaphylaxis.

Anahtar Kelimeler

Anaphylaxis, Allergens, Algorithms, Cardiopulmonary arrest

Anafilakside Hastaya Genel Yaklaşım

Öz

Özet

Anafilaksi herhangi bir alerjenle temas sonucunda gelişebilen, yaşamı tehdit eden bir hipersensitivite reaksiyonudur. Alerjene maruziyet şekli ve süresine göre değişmekle birlikte, semptomlar oluştuktan sonra hızlı kötüleşme ve kardiyopulmoner arrest meydana gelebilir. Anafilaksinin klinik semptom ve bulgularının erken tanınması, ardından acil tedaviye hızlıca başlanması mortaliteyi azaltabilir. Bu derleme anafilaksinin genel özellikleri, tedavisi ve hasta yönetimi hakkında tüm sağlık uygulayıcılarında bir farkındalık oluşturmak amacıyla düzenlenmiştir. Konu ile ilgili olarak anafilaksi ve anafilakside ileri yaşam desteği güncel algoritmaları taranarak en son bilgilerin verilmesi amaçlanmıştır.

Anahtar Kelimeler

Anafilaksi, Alerjenler, Algoritmalar, Kardiyopulmoner arrest

Kaynakça

• Doğan N. Bölüm 197-Anafilaksi. Tulunay M, Cuhruk H, Denker Ç. Irwin ve Rippe’nin Yoğun Bakım Tıbbı. 6. Baskı. Ankara. Güneş Tıp Kitabevleri. 2014;2243-2254.
• Moneret-Vautrin DA, Morisset M, Flabbee J, Beaudouin E, Kanny G. Epidemiology of life-threatening and lethal anaphylaxis: A review. Allergy 2005;60(4):443-451.
• Turner PJ, Campbell DE, Motosue MS, Campbell RL. Global trends in anaphylaxis epidemiology and clinical implications. J Allergy Clin Immunol Pract 2020;8(4):1169-1176.
• Anagnostou K, Turner PJ. Myths, facts and controversies in the diagnosis and management of anaphylaxis. Arch Dis Child 2019;104(1):83-90.
• Fasting S, Gisvold SE. Serious intraoperative problems: A five year review of 83,844 anesthetics. Can J Anaesth 2002;49(6):545-553.
• Murat I. Anaphylactic reactions during paediatric anaesthesia; results of the survey of the French Society of Paediatric Anaesthetists (ADARPEF) 1991–1992. Pediatr Anesth 1993;3(6):339-343.
• Kuhlen JL Jr, Camargo CA Jr, Balekian DS, Blumenthal KG, Guyer A, Morris T et al. Antibiotics Are the Most Commonly Identified Cause of Perioperative Hypersensitivity Reactions. J Allergy Clin Immunol Pract 2016;4(4):697-704.
• Gibbs NM, Sadleir PH, Clarke RC, Platt PR. Survival from perioperative anaphylaxis in Western Australia 2000–2009. Br J Anaesth 2013;111(4):589-593.
• Sheffer AL. Anaphylaxis. J Allergy Clin Immunol. 1985;75(2):227-233.
• Kemp SF, Lockey RF. Anaphylaxis: A review of causes and mechanisms. J Allergy Clin Immunol. 2002;110(3):341-348.
• Busse WW, Lemanske RF Jr. Asthma. N Engl J Med 2001;344(5):350-362.
• Lott C, Truhlář A, Alfonzo A, Barelli A, González-Salvado V, Hinkelbein J et al. European Resuscitation Council Guidelines 2021: Cardiac arrest in special circumstances. Resuscitation 2021;161:152-219.
• Truhlář A, Deakin CD, Soar J, Khalifa GE, Alfonzo A, Bierens JJ et al. European Resuscitation Council Guidelines for Resuscitation 2015: Section 4. Cardiac arrest in special circumstances. Resuscitation 2015;95:148-201.
• Muraro A, Roberts G, Worm M, Bilò MB, Brockow K, Fernández Rivas M et al. Anaphylaxis: guidelines from the European Academy of Allergy and Clinical Immunology. Allergy 2014;69(8):1026-1045.
• Joint Task Force on Practice Parameters; American Academy of Allergy, Asthma and Immunology; American College of Allergy, Asthma and Immunology; Joint Council of Allergy, Asthma and Immunology. The diagnosis and management of anaphylaxis: An updated practice parameter. J Allergy Clin Immunol 2005;115(3 Suppl 2):483-523.
• Singletary EM, Zideman DA, Bendall JC, Berry DA, Borra V, Carlson JN et al. First aid science collaborators. 2020 ınternational consensus on first aid science with treatment recommendations. Resuscitation 2020;156:240-282.
• Sampson HA, Muñoz-Furlong A, Campbell RL, Adkinson NF Jr, Bock SA, Branum A et al. Second symposium on the definition and management of anaphylaxis: Summary report--Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium. J Allergy Clin Immunol 2006;117(2):391-397.
• Ünal D. Perioperative Anaphylaxis İKSST Derg 2018;10(2):45-51.
• Michavila Gomez AV, Belver Gonzalez MT, Alvarez NC, Giner Muñoz MT, Hernando Sastre V, Porto Arceo JA et al. Perioperative anaphylactic reactions: Review and procedure protocol in paediatrics. Allergol Immunopathol (Madr) 2015;43(2):203-214.
• Michalska-Krzanowska G. Tryptase in diagnosing adverse suspected anaphylactic reaction. Adv Clin Exp Med 2012;21(3):403-408.
• Soar J, Böttiger BW, Carli P, Couper K, Deakin CD, Djärv T et al. European Resuscitation Council Guidelines 2021: Adult advanced life support. Resuscitation 2021;161:115-151.
• Simons FE, Ebisawa M, Sanchez-Borges M, Thong BY, Worm M, Tanno LK et al. 2015 update of the evidence base: World Allergy Organization anaphylaxis guidelines. World Allergy Organ J 2015;8(1):32.
• Shaker MS, Wallace DV, Golden DBK, Oppenheimer J, Bernstein JA, Campbell RL et al. Anaphylaxis-a 2020 practice parameter update, systematic review, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysis. J Allergy Clin Immunol 2020;145(4):1082-1123.
• Garvey LH, Dewachter P, Hepner DL, Mertes PM, Voltolini S, Clarke R et al. Management of suspected immediate perioperative allergic reactions: an international overview and consensus recommendations. Br J Anaesth 2019;123(1):50-64.
• O'Driscoll BR, Howard LS, Earis J, Mak V. British Thoracic Society Emergency Oxygen Guideline Group; BTS Emergency Oxygen Guideline Development Group. BTS guideline for oxygen use in adults in healthcare and emergency settings. Thorax 2017;72(Suppl 1):1-90.
• Padhi S, Bullock I, Li L, Stroud M. National Institute for Health and Care Excellence (NICE) Guideline Development Group. Intravenous fluid therapy for adults in hospital: summary of NICE guidance. BMJ 2013;347:7073.
• Ruiz-Garcia M, Bartra J, Alvarez O, Lakhani A, Patel S, Tang A et al. Cardiovascular changes during peanut-induced allergic reactions in human subjects. J Allergy Clin Immunol 2021;147(2):633-642.
• Harper NJN, Cook TM, Garcez T, Lucas DN, Thomas M, Kemp H et al. Anaesthesia, surgery, and life-threatening allergic reactions: Management and outcomes in the 6th National Audit Project (NAP6). Br J Anaesth 2018;121(1):172-188.
• Sheikh A, Shehata YA, Brown SG, Simons FE. Adrenaline for the treatment of anaphylaxis: cochrane systematic review. Allergy 2009;64(2):204-212.
• Gompels LL, Bethune C, Johnston SL, Gompels MM. Proposed use of adrenaline (epinephrine) in anaphylaxis and related conditions: a study of senior house officers starting accident and emergency posts. Postgrad Med J 2002;78(921):416-418.
• Alqurashi W, Ellis AK. Do Corticosteroids Prevent Biphasic Anaphylaxis? J Allergy Clin Immunol Pract 2017;5(5):1194-1205.
• Lee S, Bellolio MF, Hess EP, Campbell RL. Predictors of biphasic reactions in the emergency department for patients with anaphylaxis. J Allergy Clin Immunol Pract 2014;2(3):281-287.
• Kelso JM. A second dose of epinephrine for anaphylaxis: How often needed and how to carry. J Allergy Clin Immunol 2006;117(2):464-465.
• Simons FE, Lieberman PL, Read EJ Jr, Edwards ES. Hazards of unintentional injection of epinephrine from autoinjectors: A systematic review. Ann Allergy Asthma Immunol 2009;102(4):282-287.