EAACI guideline: Anaphylaxis (2021 update)

被引：325

作者：

Muraro, Antonella ^{[1
]}

Worm, Margitta ^{[2
]}

Alviani, Cherry ^{[3
]}

Cardona, Victoria ^{[4
,5
]}

DunnGalvin, Audrey ^{[6
,7
]}

Garvey, Lene Heise ^{[8
,9
]}

Riggioni, Carmen ^{[10
]}

de Silva, Debra ^{[11
]}

Angier, Elizabeth ^{[12
]}

Arasi, Stefania ^{[13
]}

Bellou, Abdelouahab ^{[14
,15
,16
]}

Beyer, Kirsten ^{[17
]}

Bijlhout, Diola ^{[18
]}

Bilo, Maria Beatrice ^{[19
,20
]}

Bindslev-Jensen, Carsten ^{[21
,22
]}

Brockow, Knut ^{[23
]}

Fernandez-Rivas, Montserrat ^{[24
]}

Halken, Susanne ^{[25
]}

Jensen, Britt ^{[21
,22
]}

Khaleva, Ekaterina ^{[3
]}

Michaelis, Louise J. ^{[26
,27
]}

Oude Elberink, Hanneke N. G. ^{[28
,29
]}

Regent, Lynne ^{[30
]}

Sanchez, Angel ^{[31
]}

Vlieg-Boerstra, Berber J. ^{[32
]}

Roberts, Graham ^{[3
,33
,34
]}

机构：

[1] Padua Gen Univ Hosp, Dept Women & Child Hlth, Food Allergy Referral Ctr Veneto Reg, Padua, Italy

[2] Charite Univ Med Berlin, Dept Dermatol Venerol & Allergy, Div Allergy & Immunol, Berlin, Germany

[3] Univ Southampton, Fac Med, Clin & Expt Sci & Human Dev Hlth, Southampton, Hants, England

[4] Hosp Valle De Hebron, Dept Internal Med, Allergy Sect, Barcelona, Spain

[5] ARADyAL Res Network, Barcelona, Spain

[6] Univ Coll Cork, Cork, Ireland

[7] Sechnov Univ Moscow, Moscow, Russia

[8] Copenhagen Univ Hosp Gentofte, Dept Dermatol & Allergy, Allergy Clin, Copenhagen, Denmark

[9] Univ Copenhagen, Dept Clin Med, Copenhagen, Denmark

[10] Natl Univ Singapore, Yong Loo Lin Sch Med, Dept Pediat, Allergy Immunol & Rheumatol Div, Singapore, Singapore

[11] Evidence Ctr Ltd, London, England

[12] Univ Southampton, Fac Med, Primary Care Populat Sci & Med Educ, Southampton, Hants, England

[13] Bambino Gesu Pediat Hosp, IRCCS, Area Translat Res Pediat Special, Allergy Unit, Rome, Italy

[14] European Soc Emergency Med, Brussels, Belgium

[15] Wayne State Univ, Sch Med, Dept Emergency Med, Detroit, MI USA

[16] Univ Rennes 1, Rennes, France

[17] Charite Univ Med Berlin, Dept Pediat Resp Med Immunol & Crit Care Med, Berlin, Germany

[18] Assoc Teacher Educ Europe ATEE, Brussels, Belgium

[19] Polytech Univ Marche, Dept Clin & Mol Sci, Allergy Unit, Ancona, Italy

[20] Univ Hosp Ancona, Dept Internal Med, Ancona, Italy

[21] Odense Univ Hosp, Odense Res Ctr Anaphylaxis ORCA, Dept Dermatol, Odense, Denmark

[22] Odense Univ Hosp, Odense Res Ctr Anaphylaxis ORCA, Allergy Ctr, Odense, Denmark

[23] Tech Univ Munich, Dept Dermatol & Allergy Biederstein, Munich, Germany

[24] Univ Complutense, Fac Med, Hosp Clin San Carlos, Allergy Dept,IdISSC,ARADyAL, Madrid, Spain

[25] Odense Univ Hosp, Hans Christian Andersen Childrens Hosp, Odense, Denmark

[26] Great North Childrens Hosp, Dept Paediat Immunol Allergy & Infect Dis, Newcastle Upon Tyne, Tyne & Wear, England

[27] Newcastle Univ, Populat Hlth Sci Inst, Fac Med Sci, Newcastle Upon Tyne, Tyne & Wear, England

[28] Univ Groningen, Univ Med Ctr Groningen, Dept Allergol, Groningen, Netherlands

[29] Groningen Res Inst Asthma & COPD, Groningen, Netherlands

[30] Anaphylaxis Campaign, Farnborough, Hants, England

[31] AEPNAA Spanish Assoc People Food & Latex Allergy, Madrid, Spain

[32] OLVG Hosp, Dept Paediat, Amsterdam, Netherlands

[33] Univ Hosp Southampton NHS Fdn Trust, NIHR Southampton Biomed Res Ctr, Southampton, Hants, England

[34] St Marys Hosp, David Hide Asthma & Allergy Res Ctr, Isle Of Wight, England

来源：

ALLERGY | 2022年 / 77卷 / 02期

关键词：

adults; anaphylaxis; children; guidelines; CELL ACTIVATION SYNDROMES; RISK-FACTORS; EPINEPHRINE ABSORPTION; INJECTABLE EPINEPHRINE; ALLERGIC REACTIONS; CLINICAL-FEATURES; EUROPEAN ACADEMY; CASE DEFINITIONS; NATURAL-HISTORY; MANAGEMENT PLAN;

D O I：

10.1111/all.15032

中图分类号：

R392 [医学免疫学];

学科分类号：

100102 ;

摘要：

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.

引用

页码：357 / 377

页数：21

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