| Treatment with Epinephrine (Adrenaline) in Suspected Anaphylaxis during Anesthesia in Denmark. | |
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MedLine Citation:
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PMID: 21572319 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND:: Literature on the use of epinephrine in the treatment of anaphylaxis during anesthesia is very limited. The objective of this study was to investigate how often epinephrine is used in the treatment of suspected anaphylaxis during anesthesia in Denmark and whether timing of treatment is important. METHODS:: A retrospective study of 270 patients investigated at the Danish Anaesthesia Allergy Centre after referral due to suspected anaphylaxis during anesthesia was performed. Reactions had been graded by severity: C1, mild reactions; C2, moderate reactions; C3, anaphylactic shock with circulatory instability; C4, cardiac arrest. Use of epinephrine, dosage, route of administration, and time between onset of circulatory instability and epinephrine administration were noted. RESULTS:: A total of 122 (45.2%) of referred patients had C3 or C4 reactions; of those, 101 (82.8%) received epinephrine. Route of administration was intravenous in 95 (94%) patients. Median time from onset of reported hypotension to treatment with epinephrine was 10 min (range, 1-70 min). Defining epinephrine treatment less than or equal to 10 min after onset of hypotension as early, and more than 10 min as late, infusion was needed in 12 of 60 patients (20%) treated early versus 12 of 35 patients (34%) treated late (odds ratio, 2.09) (95% confidence interval, 0.81-5.35). CONCLUSION:: Anaphylaxis may be difficult to diagnose during anesthesia, and treatment with epinephrine can be delayed as a consequence. Anaphylaxis should be considered and treated in patients with circulatory instability during anesthesia of no apparent cause who do not respond to the usual treatments. |
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Authors:
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Lene H Garvey; Bo Belhage; Mogens Krøigaard; Bent Husum; Hans-Jørgen Malling; Holger Mosbech |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-5-12 |
Journal Detail:
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Title: Anesthesiology Volume: - ISSN: 1528-1175 ISO Abbreviation: - Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-5-16 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 1300217 Medline TA: Anesthesiology Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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*Consultant, Danish Anaesthesia Allergy Centre, Allergy Clinic KAA-816, Department of Dermato-Allergology, Copenhagen University Hospital, Gentofte Hospital, ‡Consultant, Department of Anaesthesiology, Copenhagen University Hospital, Bispebjerg Hospital, §Consultant, Department of Anaesthesiology, Frederikssund Hospital, Denmark, †Department of Anaesthesia, Centre for Head and Orthopaedics, Copenhagen University Hospital, Rigshospitalet. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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