دورية أكاديمية
Perioperative anaphylaxis in children:Etiology, time sequence, and patterns of clinical reactivity
| العنوان: | Perioperative anaphylaxis in children:Etiology, time sequence, and patterns of clinical reactivity |
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| المؤلفون: | Khaleva, Ekaterina, Franz, Amber, Garvey, Lene Heise, Jay, Nicola, Ylescupidez, Alyssa, Bahnson, Henry T., du Toit, George |
| المصدر: | Khaleva , E , Franz , A , Garvey , L H , Jay , N , Ylescupidez , A , Bahnson , H T & du Toit , G 2020 , ' Perioperative anaphylaxis in children : Etiology, time sequence, and patterns of clinical reactivity ' , Pediatric Allergy and Immunology , vol. 31 , no. 1 , pp. 85-94 . https://doi.org/10.1111/pai.13124Test |
| سنة النشر: | 2020 |
| المجموعة: | University of Copenhagen: Research / Forskning ved Københavns Universitet |
| مصطلحات موضوعية: | anaphylaxis, anesthesia, children, drug allergy, epinephrine, hypersensitivity, hypotension, perioperative, skin tests, tryptase |
| الوصف: | Background: Perioperative anaphylaxis (PA) in children is an uncommon but potentially life-threatening complication associated with anesthesia. Early identification and management of PA is essential to optimize clinical outcomes. Methods: We performed a retrospective study of anesthesia records from pediatric patients with PA from centers in the United Kingdom, France, and the United States over a period of 10 years. Time sequence of clinical signs and physiological variables during PA were collected, along with results of allergy testing. Results: Twenty-nine children with PA were included. Median age was 11 years. Based on the modified Ring and Messmer Grading Scale, severe reactions were seen in 25 (86%) members of this cohort, with 4 (14%) experiencing cardiac arrest. Life-threatening hypotension was the first clinical sign of PA in 59% of cases, followed by tachycardia and bronchospasm. In 16 (55%) cases, the initial signs of PA involved multiple organ systems. When the initial signs of PA were cardiovascular and/or respiratory, more epinephrine doses were administered. Average time from initial sign of PA to treatment with epinephrine was 6 minutes (SD: 6, range: 1-25). The causative allergen was identified in 15 patients. Conclusion: Severe hypotension is the most common presenting sign of PA in children. Initial cardiovascular and/or respiratory signs are associated with the need for increased epinephrine doses. Further studies should optimize the prediction, identification, and early management of PA in children. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1111/pai.13124 |
| الإتاحة: | https://doi.org/10.1111/pai.13124Test https://curis.ku.dk/portal/da/publications/perioperative-anaphylaxis-in-childrenTest(d42baf43-5c63-4f35-90bc-a3c429cf0f82).html |
| حقوق: | info:eu-repo/semantics/closedAccess |
| رقم الانضمام: | edsbas.6100FB3B |
| قاعدة البيانات: | BASE |
| DOI: | 10.1111/pai.13124 |
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