Guiding Principles for the Recognition, Diagnosis, and Management of Infants with Anaphylaxis: An Expert Panel Consensus
Guiding Principles for the Recognition, Diagnosis, and Management of Infants with Anaphylaxis: An Expert Panel Consensus
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DOI：
10.1016/j.jaip.2018.10.052
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发表时间：
2019-04-01
影响因子：
9.4
通讯作者：
Lieberman, Philip L.
中科院分区：
文献类型：
--
作者：
Greenhawt, Matthew;Gupta, Ruchi S.;Lieberman, Philip L.
婴儿过敏反应是一种新出现的风险，其中食物过敏是最常见的原因。尽管过敏反应的表现涉及与年龄较大的儿童和成人相同的系统，但在识别非语言儿童的过敏紧急情况症状以及实施最佳治疗方面存在现实挑战。识别婴儿过敏反应可能具有挑战性，因为过敏症状和某些正常婴儿行为可能重叠。肌肉注射肾上腺素是婴儿的首选治疗方法，也适用于年龄较大的儿童和成人，并且美国食品和药物管理局批准的肾上腺素自动注射器现在可用于体重在 7.5 至 15 公斤之间的婴儿。一个专家小组试图制定婴儿过敏反应的识别、诊断和管理的指导原则，并为新指南和未来研究的制定提供框架。因此，专家组讨论了婴儿过敏反应紧急行动计划。在考虑制定未来的婴儿过敏反应指南时，卫生保健提供者应意识到需要改进对患有过敏反应的婴儿的识别、诊断和管理。未来的研究应确定并验证婴儿过敏反应诊断的临床标准，以及最严重反应的危险因素。 (C) 2019 年由爱思唯尔公司代表美国过敏、哮喘和免疫学学会出版
Infant anaphylaxis is an emerging risk, with food allergy the most common cause. Although the presentation of anaphylaxis involves the same systems as in older children and adults, there are real-world challenges to identifying symptoms of an allergic emergency in nonverbal children, as well as implementing optimal treatment. Recognition of anaphylaxis in infants can be challenging because allergic symptoms and certain normal infant behaviors may overlap. Intramuscular epinephrine is the treatment of choice for infants, as it is for older children and adults, and an epinephrine autoinjector approved by the Food and Drug Administration is now available for infants weighing between 7.5 and 15 kg. A panel of experts sought to develop guiding principles for the recognition, diagnosis, and management of anaphylaxis in infants, and provide a framework for the development of new guidelines and future research. Accordingly, anaphylaxis emergency action planning for infants was addressed by the panel. In considering formation of future infant anaphylaxis guidelines, health care providers should be aware of the needs to improve the recognition, diagnosis, and management of infants with anaphylaxis. Future research should identify and validate clinical criteria for the diagnosis of anaphylaxis in infants, as well as risk factors for the most severe reactions. (C) 2019 Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology