Evidence update for the treatment of anaphylaxis.

Evidence update for the treatment of anaphylaxis.
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DOI:
10.1016/j.resuscitation.2021.04.010
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发表时间:
2021-04-23
期刊:
影响因子:
6.5
通讯作者:
Turner PJ
Turner PJ
中科院分区:
医学2区
文献类型:
--
作者:
Dodd A;Hughes A;Sargant N;Whyte AF;Soar J;Turner PJ

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英国复苏委员会更新了医疗保健提供者过敏反应紧急治疗指南。作为这一过程的一部分,指南工作组进行了证据审查,采用国际公认的方法进行采纳、改编和重新制定指南,该方法基于建议评估、制定和评价分级 (GRADE) 证据到决策 (EtD) 框架(称为 GRADE-ADOLOPMENT)。已经进行了一些重大更改,这些更改将反映在更新后的指南中。其中包括: 如果过敏反应症状未缓解,强调 5 分钟后重复肌内注射肾上腺素;不再常规推荐皮质类固醇(例如氢化可的松)用于过敏反应的紧急治疗;对肾上腺素初始治疗难治的反应进行干预;反对使用抗组胺药来紧急治疗过敏反应的建议;与过敏反应后观察持续时间和出院时间相关的指导。
The Resuscitation Council UK has updated its Guideline for healthcare providers on the Emergency treatment of anaphylaxis. As part of this process, an evidence review was undertaken by the Guideline Working Group, using an internationally-accepted approach for adoption, adaptation, and de novo guideline development based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE) evidence to decision (EtD) framework, referred to as GRADE-ADOLOPMENT. A number of significant changes have been made, which will be reflected in the updated Guideline. These include: emphasis on repeating intramuscular adrenaline doses after 5 min if symptoms of anaphylaxis do not resolve; corticosteroids (e.g. hydrocortisone) no longer being routinely recommended for the emergency treatment of anaphylaxis; interventions for reactions which are refractory to initial treatment with adrenaline; a recommendation against the use of antihistamines for the acute management of anaphylaxis; and guidance relating to the duration of observation following anaphylaxis, and timing of discharge.
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