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Perioperative anaphylactic reactions: Review and procedure protocol in paediatrics
Michavila Gomez, AV; Belver Gonzalez, MT; Cortés Alvarez, N; Giner Muñoz, MT; Hernando Sastre, V; Porto Arceo, JA; Vila Induráin, B.
Afiliación
  • Michavila Gomez, AV; Hospital General de Castellón. Castellón. Spain
  • Belver Gonzalez, MT; Hospital Infantil La Paz. Madrid. Spain
  • Cortés Alvarez, N; Hospital Mutua de Tarrasa. Barcelona. Spain
  • Giner Muñoz, MT; Hospital Sant Joan de Déu. Barcelona. Spain
  • Hernando Sastre, V; Hospital Virgen de la Arrixaca. Barcelona. Spain
  • Porto Arceo, JA; Clínico Universitario. Compostela. Spain
  • Vila Induráin, B; Hospital Vall d´Hebron. Barcelona. Spain
Allergol. immunopatol ; 43(2): 203-214, mar.-abr. 2015. tab
Article en En | IBECS | ID: ibc-134688
Biblioteca responsable: ES1.1
Ubicación: BNCS
ABSTRACT
Perioperative anaphylactic reactions are immediate, hypersensitive reactions that are potentially life-threatening resulting from a sudden release of mediators from mast cells and basophiles, due to either immune (IgE or non-IgE mediated) or non-immune mechanisms. The most frequent causing agents are neuromuscular blocking agents (NMBAs), latex and antibiotics, with latex being the first cause in paediatrics. With regard to perioperative anaphylactic reactions, the usual early signs and symptoms of an anaphylactic reaction could be overlooked or erroneously interpreted and non-severe anaphylaxis could go undetected, with a risk of more severe reactions in the future. Using the data registered on the anaesthesia sheet, it is essential to establish a chronological relationship between drugs and/or substances administered and the reaction observed. An elevated level of tryptase confirms an anaphylactic reaction, but this does not usually increase in the absence of compromised circulation. An allergy study should be carried out preferably between 4 and 6 weeks after the reaction, using a combination of specific IgE, skin and controlled exposure tests (if indicated). Test sensitivity is good for NMBAs, latex, antibiotics, chlorhexidine, gelatine and povidone, and poor for barbiturates, opiates (these can give false positives since they are histamine releasers) and benzodiazepines. Special preventive measures should be taken, especially in the case of latex. We present the maximum concentrations recommended for skin tests, the recommended dosage to treat anaphylactic reactions in paediatrics and a procedure algorithm for the allergological study of these reactions
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Colección: 06-national / ES Base de datos: IBECS Asunto principal: Pediatría / Pruebas Cutáneas / Protocolos Clínicos / Hipersensibilidad / Anafilaxia Tipo de estudio: Guideline Límite: Female / Humans / Male Idioma: En Revista: Allergol. immunopatol Año: 2015 Tipo del documento: Article
Buscar en Google
Colección: 06-national / ES Base de datos: IBECS Asunto principal: Pediatría / Pruebas Cutáneas / Protocolos Clínicos / Hipersensibilidad / Anafilaxia Tipo de estudio: Guideline Límite: Female / Humans / Male Idioma: En Revista: Allergol. immunopatol Año: 2015 Tipo del documento: Article