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Scandinavian Clinical Practice Guidelines on the diagnosis, management and follow‐up of anaphylaxis during anaesthesia *
Author(s) -
Kroigaard M.,
Garvey L. H.,
Gillberg L.,
Johansson S. G. O.,
Mosbech H.,
Florvaag E.,
Harboe T.,
Eriksson L. I.,
Dahlgren G.,
SeemanLodding H.,
Takala R.,
Wattwil M.,
Hirlekar G.,
Dahlén B.,
Guttormsen A. B.
Publication year - 2007
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.2007.01313.x
Subject(s) - medicine , anaphylaxis , clinical practice , anaphylactic reactions , intensive care medicine , epidemiology , incidence (geometry) , general anaesthesia , anesthesia , family medicine , allergy , physics , optics , immunology
The present approach to the diagnosis, management and follow‐up of anaphylaxis during anaesthesia varies in the Scandinavian countries. The main purpose of these Scandinavian Clinical Practice Guidelines is to increase the awareness about anaphylaxis during anaesthesia amongst anaesthesiologists. It is hoped that increased focus on the subject will lead to prompt diagnosis, rapid and correct treatment, and standardised management of patients with anaphylactic reactions during anaesthesia across Scandinavia. The recommendations are based on the best available evidence in the literature, which, owing to the rare and unforeseeable nature of anaphylaxis, mainly includes case series and expert opinion (grade of evidence IV and V). These guidelines include an overview of the epidemiology of anaphylactic reactions during anaesthesia. A treatment algorithm is suggested, with emphasis on the incremental titration of adrenaline (epinephrine) and fluid therapy as first‐line treatment. Recommendations for primary and secondary follow‐up are given, bearing in mind that there are variations in geography and resources in the different countries. A list of National Centres from which anaesthesiologists can seek advice concerning follow‐up procedures is provided. In addition, an algorithm is included with advice on how to manage patients with previous suspected anaphylaxis during anaesthesia. Lastly, Appendix 2 provides an overview of the incidence, mechanisms and possibilities for follow‐up for some common drug groups.