LoVerde Daniel, Files Daniel Clark, Krishnaswamy Guha
1Division of Pulmonary, Critical Care, Allergy and Immunology, Department of Medicine, Wake Forest Baptist Medical Center, Winston-Salem, NC.2Division of Allergy and Clinical Immunology, Department of Medicine, W.G. (Bill) Hefner VA Medical Center, Salisbury, NC.
Crit Care Med. 2017 Apr;45(4):725-735. doi: 10.1097/CCM.0000000000002281.
Angioedema is a potentially life-threatening occurrence that is encountered by critical care providers. The mechanistic understanding of angioedema syndromes has improved in recent years, and novel medications are available that improve outcomes from these syndromes. This clinically focused review will describe the underlying genetics, pathophysiology, classification and treatment of angioedema syndromes, with an emphasis on the novel pharmacologic agents that have recently become available for acute treatment.
A MEDLINE search was conducted with the MeSH terms angioedema, acquired angioedema, hereditary angioedema type III, and angiotensin converting enzyme inhibitor-induced angioedema.
Selected publications describing angioedema, clinical trials, diagnosis, management, and genetics were retrieved (reviews, guidelines, clinical trials, case series), and their bibliographies were also reviewed to identify relevant publications.
Data from the relevant publications were reviewed, summarized and the information synthesized.
The data obtained were used to describe the current state of diagnosis and management of various angioedema syndromes.
Angioedema is a life-threatening syndrome with multiple subtypes, each with a distinct pathophysiology. We present an evidence-based approach to the diagnosis and suggested management of various subtypes of angioedema. Securing the airway remains the most important intervention, followed by administration of both established and more novel pharmacologic interventions based on disease pathology.
血管性水肿是重症监护人员可能会遇到的一种潜在危及生命的情况。近年来，对血管性水肿综合征的机制认识有所提高，并且有可改善这些综合征预后的新型药物。这篇以临床为重点的综述将描述血管性水肿综合征的潜在遗传学、病理生理学、分类及治疗，重点是近期可用于急性治疗的新型药物。
使用医学主题词血管性水肿、获得性血管性水肿、III型遗传性血管性水肿和血管紧张素转换酶抑制剂诱导的血管性水肿进行了医学文献数据库检索。
检索了描述血管性水肿、临床试验、诊断、管理和遗传学的选定出版物（综述、指南、临床试验、病例系列），并对其参考文献进行了审查以识别相关出版物。
对相关出版物的数据进行了审查、总结并综合了信息。
所获得的数据用于描述各种血管性水肿综合征的诊断和管理现状。
血管性水肿是一种有多种亚型的危及生命的综合征，每种亚型都有独特的病理生理学。我们提出了一种基于证据的方法来诊断和建议管理各种亚型的血管性水肿。确保气道安全仍然是最重要的干预措施，其次是根据疾病病理给予既定的和更新的药物干预。
