Pharmacologic and non-pharmacologic interventions to prevent hypersensitivity reactions of non-ionic iodinated contrast media: a systematic review protocol.
Pharmacologic and non-pharmacologic interventions to prevent hypersensitivity reactions of non-ionic iodinated contrast media: a systematic review protocol.
复制标题
预防非离子碘造影剂过敏反应的药理学和非药理学干预措施：系统评价方案。
DOI：
10.1136/bmjopen-2019-033023
复制
发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Teruhiko Terasawa,
中科院分区：
文献类型：
--
作者：
Hiroyasu Umakoshi;Takashi Nihashi;Hironori Shimamoto;Takehiro Yamada;Hiroaki Ishiguchi;Akira Takada;Naoki Hirasawa;Shunichi Ishihara;Yasuo Takehara;Shinji Naganawa;Matthew Davenport;Teruhiko Terasawa,
碘造影剂常用于医学成像，可引起超敏反应，包括罕见但严重危及生命的反应。虽然已经提出了几种预防严重反应的方法，但其效果尚不清楚。因此，我们旨在系统地回顾药物和非药物干预的预防作用以及急性超敏反应的预测因素。方法和分析我们将检索PubMed、EMBASE和Cochrane Central Register of Controlled Trials数据库（从1990年1月1日至2019年12月31日），并检查符合条件的研究的参考书目、相关综述文章和临床实践指南。我们将包括任何设计的前瞻性和回顾性研究，以评估药物和非药物预防性干预对非离子碘化造影剂不良反应的影响。两名评估员将独立提取研究和干预的特征以及定量结果。两名独立审稿人将使用标准设计特异性效度评估工具评估偏倚风险。主要结果将是减少急性造影剂引起的超敏反应。次要结局将包括与造影剂诱导的急性超敏反应的发展相关的特征，以及与特定预防干预相关的不良事件。独特的用药前方案（如剂量、药物和持续时间）和非药物策略将分别进行分析。平均风险和高风险患者将被分开考虑。如果合适，将进行荟萃分析。伦理和传播伦理批准不适用，因为这将是对公开可用数据的二次分析。分析结果将提交在同行评议的期刊上发表。普洛斯彼罗注册号crd42019134003
IntroductionIodinated contrast media are commonly used in medical imaging and can cause hypersensitivity reactions, including rare but severe life-threatening reactions. Although several prophylactic approaches have been proposed for severe reactions, their effects remain unclear. Therefore, we aim to review systematically the preventive effects of pharmacologic and non-pharmacologic interventions and predictors of acute, hypersensitivity reactions.Methods and analysisWe will search the PubMed, EMBASE and Cochrane Central Register of Controlled Trials databases from 1 January 1990 through 31 December 2019 and will examine the bibliographies of eligible studies, pertinent review articles and clinical practice guidelines. We will include prospective and retrospective studies of any design that evaluated the effects of pharmacological and non-pharmacological preventive interventions for adverse reactions of non-ionic iodinated contrast media. Two assessors will independently extract the characteristics of the study and intervention and the quantitative results. Two independent reviewers will assess the risk of bias using standard design-specific validity assessment tools. The primary outcome will be reduction in acute contrast media-induced hypersensitivity reactions. The secondary outcomes will include characteristics associated with the development of contrast media-induced acute hypersensitivity reactions, and adverse events associated with specific preventive interventions. Unique premedication regimens (eg, dose, drug and duration) and non-pharmacological strategies will be analysed separately. Average-risk and high-risk patients will be considered separately. A meta-analysis will be performed if appropriate.Ethics and disseminationEthics approval is not applicable, as this will be a secondary analysis of publicly available data. The results of the analysis will be submitted for publication in a peer reviewed journal.PROSPERO registration numberCRD42019134003