RT Book, Section
A1 Pelletier, Teresa
A1 Mehrotra, Priyanka
A1 Schussler, Edith
A2 Schmidt, Gregory A.
A2 Kress, John P.
A2 Douglas, Ivor S.
SR Print(0)
ID 1201812522
T1 Anaphylaxis
T2 Hall, Schmidt and Wood’s Principles of Critical Care, 5<sup>th</sup> Edition
YR 2023
FD 2023
PB McGraw Hill
PP New York, NY
SN 9781264264353
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1201812522
RD 2024/10/10
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.