Dodd Amy, Hughes Anna, Sargant Nicholas, Whyte Andrew F, Soar Jasmeet, Turner Paul J
Severn Deanery, UK.
Bristol Royal Hospital for Children, Bristol, UK.
Resuscitation. 2021 Apr 23;163:86-96. doi: 10.1016/j.resuscitation.2021.04.010.
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.
英国复苏委员会已更新其针对医疗服务提供者的过敏反应紧急治疗指南。在此过程中，指南工作组采用了一种国际认可的方法进行证据审查，该方法基于推荐分级评估、制定与评价（GRADE）证据到决策（EtD）框架来制定、改编和全新制定指南，即GRADE-ADOLOPMENT。已做出多项重大更改，这些更改将在更新后的指南中体现。其中包括：强调如果过敏反应症状未缓解，5分钟后重复肌内注射肾上腺素剂量；不再常规推荐使用皮质类固醇（如氢化可的松）进行过敏反应的紧急治疗；针对对初始肾上腺素治疗无效的反应的干预措施；不建议使用抗组胺药进行过敏反应的急性处理；以及关于过敏反应后观察持续时间和出院时间的指导。
