EAACI guidelines: Anaphylaxis (2021 update),Allergy

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EAACI guidelines: Anaphylaxis (2021 update)
Allergy ( IF 12.6 ) Pub Date : 2021-08-03 , DOI: 10.1111/all.15032
Antonella Muraro ₁ , Margitta Worm ₂ , Cherry Alviani ₃ , Victoria Cardona ₄ , Audrey DunnGalvin _{5,

6} , Lene Heise Garvey _{7,

8} , Carmen Riggioni ₉ , Debra de Silva ₁₀ , Elizabeth Angier ₁₁ , Stefania Arasi ₁₂ , Abdelouahab Bellou _{13,

14,

15} , Kirsten Beyer ₁₆ , Diola Bijlhout ₁₇ , Maria Beatrice Bilò _{18,

19} , Carsten Bindslev-Jensen ₂₀ , Knut Brockow ₂₁ , Montserrat Fernandez-Rivas ₂₂ , Susanne Halken ₂₃ , Britt Jensen ₂₀ , Ekaterina Khaleva ₃ , Louise J Michaelis _{24,

25} , Hanneke N G Oude Elberink ₂₆ , Lynne Regent ₂₇ , Angel Sanchez ₂₈ , Berber J Vlieg-Boerstra ₂₉ , Graham Roberts _{3,

30,

31} ,

Affiliation

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.
Clinical and Experimental Sciences and Human Development in Health, Faculty of Medicine, University of Southampton, UK.
Allergy Section, Department of Internal Medicine, Hospital Vall d'Hebron & ARADyAL Research Network, Barcelona, Spain.
University College Cork, Cork, Ireland.
Sechnov University Moscow, Moscow, Russia.
Allergy Clinic, Department of Dermatology and allergy, Copenhagen University Hospital Gentofte, Copenhagen, Denmark.
Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Allergy, Immunology and Rheumatology Division, Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore.
The Evidence Centre Ltd, London, UK.
Primary Care, Population Science and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK.
Allergy Unit - Area of Translational Research in Pediatric Specialities, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
European Society for Emergency Medicine, Brussels, Belgium.
Department of Emergency Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA.
University of Rennes 1, Rennes, France.
Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany.
Association for Teacher Education in Europe (ATEE, Brussels, Belgium.
Allergy Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy.
Department of Internal Medicine, University Hospital of Ancona, Ancona, Italy.
Department of Dermatology and Allergy Centre, Odense Research Centre for Anaphylaxis (ORCA), Odense University Hospital, Odense, Denmark.
Department of Dermatology and Allergy Biederstein, Technical University of Munich, Munich, Germany.
Allergy Department, Hospital Clinico San Carlos, Facultad Medicina Universidad Complutense, IdISSC, ARADyAL, Madrid, Spain.
Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.
Department of Paediatric Immunology, Allergy, and Infectious Diseases, Great North Children's Hospital, Newcastle upon Tyne, UK.
Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
Department of Allergology, University Medical Center Groningen, University of Groningen, and Groningen Research Institute for Asthma and COPD, Groningen, The Netherlands.
Anaphylaxis Campaign, Farnborough, UK.
AEPNAA Spanish Association for People with Food and Latex Allergy, Madrid, Spain.
Department of Paediatrics, OLVG Hospital, Amsterdam, The Netherlands.
NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight, UK.

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.

中文翻译：

EAACI 指南：过敏反应（2021 年更新）

过敏反应是一种临床紧急情况，所有医疗保健专业人员都需要能够识别和管理。欧洲过敏和临床免疫学过敏反应多学科工作组更新了 2014 年指南。该指南是使用 AGREE II 框架和 GRADE 方法制定的。对证据进行了系统审查，并通过权衡利弊提出了建议。该指南由外部专家进行同行评审，并在公众咨询中进行审查。建议使用临床标准来识别过敏反应，并进行血液采样，以便稍后测量类胰蛋白酶。建议立即使用肌肉注射肾上腺素作为一线治疗，并为社区患者提供肾上腺素自动注射器。应提供肾上腺素自动注射器装置的药代动力学数据。建议对有过敏反应风险的人进行结构化、全面的培训。建议对医疗保健专业人员进行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。治疗过敏反应的证据大多仍处于非常低的水平。迫切需要优先考虑有可能改善对有过敏反应风险的患者的管理的临床试验。

更新日期：2021-08-03

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