Food Allergy Referral Centre Veneto Region, Department of Women and Child Health, Padua General University Hospital, Padua, Italy.
Division of Allergy and Immunology, Department of Dermatology, Venerology and Allergy, Charité Universitätsmedizin Berlin, Germany.
Allergy. 2022 Feb;77(2):357-377. doi: 10.1111/all.15032. Epub 2021 Sep 1.
Anaphylaxis is a clinical emergency which all healthcare professionals need to be able to recognize and manage. The European Academy of Allergy and Clinical Immunology Anaphylaxis multidisciplinary Task Force has updated the 2014 guideline. The guideline was developed using the AGREE II framework and the GRADE approach. The evidence was systematically reviewed and recommendations were created by weighing up benefits and harms. The guideline was peer-reviewed by external experts and reviewed in a public consultation. The use of clinical criteria to identify anaphylaxis is suggested with blood sampling for the later measurement of tryptase. The prompt use of intramuscular adrenaline as first-line management is recommended with the availability of adrenaline autoinjectors to patients in the community. Pharmacokinetic data should be provided for adrenaline autoinjector devices. Structured, comprehensive training for people at risk of anaphylaxis is recommended. Simulation training and visual prompts for healthcare professionals are suggested to improve the management of anaphylaxis. It is suggested that school policies reflect anaphylaxis guidelines. The evidence for the management of anaphylaxis remains mostly at a very low level. There is an urgent need to prioritize clinical trials with the potential to improve the management of patients at risk of anaphylaxis.
过敏反应是一种临床急症，所有医疗保健专业人员都需要能够识别和处理。欧洲过敏与临床免疫学学会过敏反应多学科工作组更新了 2014 年的指南。该指南使用 AGREE II 框架和 GRADE 方法制定。使用系统评价方法对证据进行了审查，并通过权衡利弊来制定建议。该指南由外部专家进行同行评审，并在公开咨询中进行了审查。建议使用临床标准来识别过敏反应，并进行血液采样以测量后期的类胰蛋白酶。建议在社区中为患者提供肾上腺素自动注射器，以便及时使用肌肉内肾上腺素作为一线治疗。应为肾上腺素自动注射器设备提供药代动力学数据。建议对过敏反应风险人群进行结构化、全面的培训。建议为医疗保健专业人员提供模拟培训和视觉提示，以改善过敏反应的管理。建议学校政策反映过敏反应指南。过敏反应管理的证据主要仍处于非常低的水平。迫切需要优先进行临床试验，以提高对过敏反应风险患者的管理。
