Ranft A, Kochs E F
Klinik für Anästhesiologie am Klinikum rechts der Isar der Technischen Universität München.
Anasthesiol Intensivmed Notfallmed Schmerzther. 2004 Jan;39(1):2-9. doi: 10.1055/s-2004-815709.
In the present review, guidelines and recommendations for the treatment of anaphylactic reactions are presented and evaluated. Herefore, publications of German and non-German societies and expert groups have been selected and, in addition to that, we have chosen a number of articles that were cited frequently and, as far as we are concerned, have a relevant meaning for this theme. None of the traditionally applied remedies - epinephrine and intravascular volume, histamine receptor blockade, inhaled betamimetics and steroids - have been proven efficacious by means of evidence-based medicine. Due to the variability of the symptoms of anaphylaxis, it is widely accepted that such a clinical proof is unlikely to come. In contrast to this, there is lack of a consense as to substantial elements of the therapy, above all with regard to dosage and application mode for epinephrine and likewise concerning amount and kind of intravenous fluids. Hence, the physician in charge has to face the necessity either to follow the guidelines of his institution (if there are any) or to blend his own therapeutic regime according to his own convictions.
在本综述中，我们对过敏性反应治疗的指南和建议进行了阐述与评估。为此，我们选取了德国及非德国学会和专家组的出版物，此外，我们还挑选了一些被频繁引用且就我们而言与该主题具有相关意义的文章。传统应用的治疗方法——肾上腺素、血管内容量补充、组胺受体阻断、吸入性β受体激动剂和类固醇——均未通过循证医学证明其有效性。由于过敏反应症状的变异性，人们普遍认为这种临床证据不太可能出现。与此形成对比的是，在治疗的关键要素方面缺乏共识，尤其是在肾上腺素的剂量和应用方式以及静脉输液的量和种类方面。因此，主治医生必须面对这样的必要性：要么遵循其所在机构的指南（如果有），要么根据自己的信念制定自己的治疗方案。
