دورية أكاديمية
Paediatric perioperative hypersensitivity:the performance of the current consensus formula and the effect of uneventful anaesthesia on serum tryptase
| العنوان: | Paediatric perioperative hypersensitivity:the performance of the current consensus formula and the effect of uneventful anaesthesia on serum tryptase |
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| المؤلفون: | Vlaeminck, Nils, Poorten, Marie Line van der, Nygaard Madsen, Cecilie, Bech Melchiors, Birgitte, Michel, Moïse, Gonzalez, Constance, Schrijvers, Rik, Elst, Jessy, Mertens, Christel, Saldien, Vera, Vitte, Joana, Garvey, Lene H., Sabato, Vito, Ebo, Didier G. |
| المصدر: | Vlaeminck , N , Poorten , M L V D , Nygaard Madsen , C , Bech Melchiors , B , Michel , M , Gonzalez , C , Schrijvers , R , Elst , J , Mertens , C , Saldien , V , Vitte , J , Garvey , L H , Sabato , V & Ebo , D G 2024 , ' Paediatric perioperative hypersensitivity : the performance of the current consensus formula and the effect of uneventful anaesthesia on serum tryptase ' , BJA Open , vol. 9 , 100254 . https://doi.org/10.1016/j.bjao.2023.100254Test |
| سنة النشر: | 2024 |
| المجموعة: | University of Copenhagen: Research / Forskning ved Københavns Universitet |
| مصطلحات موضوعية: | Formula for mast cell activation in children, Paediatric POH, Paired serum tryptase, Performance of consensus formula, Perioperative anaphylaxis, Perioperative hypersensitivity, POH diagnosis, Uneventful anaesthesia |
| الوصف: | Background Paired sampling of acute (aST) and basal (bST) serum tryptase has been recommended when investigating patients with a suspected perioperative hypersensitivity (POH) reaction. In the current consensus formula, an aST value exceeding (1.2×bST+2) confirms mast cell activation. The current consensus formula has been validated in adults but not in children. Methods We prospectively included 96 children who underwent uneventful anaesthesia and sampled serum tryptase at baseline and 60–90 min after induction. Tryptase changes were then compared with those in 94 children with suspected POH who were retrospectively included from four reference centres in Belgium, France, and Denmark. Results We observed a median decrease in serum tryptase during uneventful anaesthesia of 0.41 μg L−1 (–15.9%; P<0.001). The current consensus formula identified mast cell activation in 31.9% of paediatric POH patients. After generating receiver operating characteristic curves through 100 repeated five-fold cross-validation, aST>bST+0.71 was identified as the optimal cut-off point to identify mast cell activation. This new paediatric formula has higher sensitivity than the current consensus formula (53.2% vs 31.9%, P<0.001) with a specificity of 96.9%. Analysis in the subpopulation where a culprit was identified and in grade 3–4 reactions similarly yielded higher sensitivity for the new paediatric formula when compared with the current consensus formula (85.3% vs 61.8%; P=0.008 and 78.0% vs 48.8%; P<0.001, respectively). Internally cross-validated sensitivity and specificity were 53.3% and 93.3%, respectively. Conclusions This is the first study suggesting the need for an adjusted formula in children to identify perioperative mast cell activation as tryptase is significantly lowered during uneventful anaesthesia. We propose a new formula (aST>bST+0.71) which performs significantly better than the current consensus formula in our multicentric paediatric population. ; Background: Paired sampling of acute (aST) and ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| DOI: | 10.1016/j.bjao.2023.100254 |
| الإتاحة: | https://doi.org/10.1016/j.bjao.2023.100254Test https://curis.ku.dk/portal/da/publications/paediatric-perioperative-hypersensitivityTest(2f1aa999-100d-4a1e-86e5-1e16ab1d94b8).html https://curis.ku.dk/ws/files/381064766/1_s2.0_S2772609623001338_main.pdfTest |
| حقوق: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.5F2DBB58 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1016/j.bjao.2023.100254 |
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