TY - CHAP M1 - Book, Section TI - Anaphylaxis A1 - Pelletier, Teresa A1 - Mehrotra, Priyanka A1 - Schussler, Edith A2 - Schmidt, Gregory A. A2 - Kress, John P. A2 - Douglas, Ivor S. Y1 - 2023 N1 - T2 - Hall, Schmidt and Wood’s Principles of Critical Care, 5th Edition AB - KEY POINTSAnaphylaxis is an acute, systemic, and potentially fatal hypersensitivity reaction with variable presentation including cutaneous, respiratory cardiovascular, and/or gastrointestinal manifestations.It is rapid in onset with symptoms developing 5-30 minutes after exposure to allergen, though in some cases it can be as long as few hours.Cutaneous symptoms are common but hemodynamic collapse and shock can occur in the absence of these.The prevalence of anaphylaxis is increasing, as are hospitalizations for anaphylaxis; however, fatality rates are stable.Rapid administration of intramuscular epinephrine is the first-line treatment of choice for both in-hospital and out-of-hospital treatment.The most common triggers for anaphylaxis in the outpatient setting are foods, medication, and insect venom. The majority of anaphylaxis presenting to the emergency room is due to food. Medications are the most common cause of inpatient anaphylaxis.Risk factors for anaphylaxis include asthma, atopy, pregnancy, cardiovascular disease, and other comorbidities.Cofactors including exercise, alcohol, stress, infection, and medications such as nonsteroidal anti-inflammatory drugs, β-blockers, and angiotensin-converting enzyme inhibitors may increase both risk and severity of reactions.Serum tryptase can be helpful in confirming anaphylaxis but careful history and physical examination are the most important factors in the diagnosis of anaphylaxis.Anaphylaxis is the most severe and potentially fatal form of immediate hypersensitivity reaction. Prompt recognition, administration of epinephrine, and intravascular volume replacement are key to preventing potentially fatal outcomes. SN - PB - McGraw Hill CY - New York, NY Y2 - 2024/10/14 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=1201812522 ER -