Who Needs Epinephrine? Anaphylaxis, Autoinjectors, and Parachutes.
Who Needs Epinephrine? Anaphylaxis, Autoinjectors, and Parachutes.
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DOI：
10.1016/j.jaip.2023.02.002
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发表时间：
2023-04
影响因子：
9.4
通讯作者：
Turner, Paul J.
中科院分区：
文献类型：
--
作者：
Dribin, Timothy E.;Waserman, Susan;Turner, Paul J.
国际指南规定，肌内（IM）肾上腺素（肾上腺素）是过敏反应的一线治疗药物，具有良好的安全性特征。肾上腺素自动注射器（EAI）的可用性极大地促进了社区环境中IM肾上腺素的非专业给药。然而，肾上腺素使用的关键领域仍然存在不确定性。这些包括EAI处方的变化，什么症状应该提示肾上腺素给药，给药后是否需要联系紧急医疗服务（EMS），以及通过EAI给予肾上腺素是否降低过敏反应的死亡率或改善生活质量措施。我们对这些问题作出了平衡的评论。越来越多的人认识到，对肾上腺素的不良反应，特别是在2次给药后，是严重程度和紧急升级需求的有用标志。对单次肾上腺素剂量有反应的患者可能不需要EMS激活或急诊室转移，但需要数据来证明这种方法的安全性。最后，必须建议有过敏反应风险的患者不要过度依赖EAI。
International guidelines stipulate that intramuscular (IM) epinephrine (adrenaline) is the first-line treatment for anaphylaxis, with an established good safety profile. The availability of epinephrine autoinjectors (EAI) has greatly facilitated the lay administration of IM epinephrine in community settings. However, key areas of uncertainty remain around epinephrine usage. These include variations in prescribing EAI, what symptoms should prompt epinephrine administration, whether emergency medical services (EMS) need to be contacted after administration, and whether epinephrine administered via EAI reduces mortality from anaphylaxis or improves quality of life measures. We provide a balanced commentary on these issues. There is increasing recognition that a poor response to epinephrine, particularly after 2 doses, is a useful marker of severity and the need for urgent escalation. It is likely that patients who respond to a single epinephrine dose do not require EMS activation or emergency department transfer, but data are needed to demonstrate the safety of this approach. Lastly, patients at risk of anaphylaxis must be counseled against over-reliance on EAI alone.
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影响因子：
14.2
作者：
Bock, SA;Muñoz-Furlong, A;Sampson, HA
通讯作者：
Sampson, HA
DOI：
10.1016/j.jaci.2010.10.007
发表时间：
2010-12
期刊：
The Journal of allergy and clinical immunology
影响因子：
--
作者：
NIAID-Sponsored Expert Panel;Boyce JA;Assa'ad A;Burks AW;Jones SM;Sampson HA;Wood RA;Plaut M;Cooper SF;Fenton MJ;Arshad SH;Bahna SL;Beck LA;Byrd-Bredbenner C;Camargo CA Jr;Eichenfield L;Furuta GT;Hanifin JM;Jones C;Kraft M;Levy BD;Lieberman P;Luccioli S;McCall KM;Schneider LC;Simon RA;Simons FE;Teach SJ;Yawn BP;Schwaninger JM
通讯作者：
Schwaninger JM
影响因子：
6.5
作者：
Dodd A;Hughes A;Sargant N;Whyte AF;Soar J;Turner PJ
通讯作者：
Turner PJ
影响因子：
4.4
作者：
Choi, Yoo Jin;Kim, Joonghee;Park, Joong Wan
通讯作者：
Park, Joong Wan
影响因子：
14.2
作者：
Elberink, JNGO;de Monchy, JGR;Dubois, AEJ
通讯作者：
Dubois, AEJ