Anaphylaxis During Radiological Procedures and in the Peri-operative Setting

Dewachter, Pascale; Hepner, David L.

doi:10.1007/978-1-60327-951-2_11

Cited by 3 publications

(2 citation statements)

References 126 publications

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“…Acute coronary syndromes (Kounis syndrome) associated with mast cell activation, also called allergic angina or allergic myocardial infarction, have been reported with the occurrence of allergic hypersensitivity [36]. This condition is rare.…”

Section: Kounis Syndromementioning

confidence: 98%

Perioperative Anaphylaxis: What Should Be Known?

Dewachter

Mouton‐Faivre²,

Hepner

2015

Curr Allergy Asthma Rep

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Perioperative anaphylaxis is a unique condition as a result of the additive cardiovascular effects of anesthetics on the cardiovascular disturbances of anaphylaxis. It occurs mainly in adulthood, primarily follows anesthetic induction, and for the most part, is an IgE-mediated pathomechanism. Neuromuscular blocking agents (NMBAs) and antibiotics are the main culprit drugs, while latex is now infrequently involved. The Ring and Messmer scale is a useful tool for demonstrating the clinical severity of perioperative immediate hypersensitivity and guiding its management. Grades III and IV are life-threatening and are referred to as anaphylaxis. Three different clinical patterns of grade III may be observed, where cardiovascular collapse is the cardinal sign. Grade IV presents as cardiac arrest. The initial diagnosis is presumptive, whereas the etiological assessment is linked to the clinical presentation, tryptase levels, and skin test results. Since anaphylaxis presents with significant hypovolemia and vasoplegia, aggressive fluid therapy and epinephrine are the cornerstones of management. Whenever possible, anesthetic discontinuation is also recommended. Scientific evidence in favor of preemptive therapeutic strategies to prevent anaphylaxis in the operative setting is lacking.

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Section: Kounis Syndromementioning

confidence: 98%

Perioperative Anaphylaxis: What Should Be Known?

Dewachter

Mouton‐Faivre²,

Hepner

2015

Curr Allergy Asthma Rep

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“…5 6 Although the first reaction in our case was grade 3, a mild secondary reaction (grade 1: urticaria and erythema) occurred. More serious complications, such as respiratory problems and cardiovascular collapse, have been reported 2.…”

Section: Discussionmentioning

confidence: 62%

Feeling blue, going green and finding other attractive alternatives: a case of biphasic anaphylaxis to patent blue and a literature review of alternative sentinel node localisation methods

et al. 2015

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Patent blue dye is used for sentinel lymph node localisation in order to stage the axilla in patients with breast cancer. Patent blue is one of the most common dyes used across the UK, however, the incidence of adverse effects seems to be increasing. This case highlights our experience of a biphasic anaphylactic reaction to patent blue dye, and we conduct a brief literature review of alternative and more novel methods to adequately visualise the lymphatics for sentinel lymph node biopsy.

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Prevention of anaphylaxis in healthcare settings

Worth¹,

Sheikh²

2013

Expert Review of Clinical Immunology

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In this paper, we review recent evidence on preventing anaphylaxis in healthcare settings and contexts where the risk of developing anaphylaxis is known to be increased. These include investigation units in which patients are undergoing challenge testing, outpatient clinics undertaking immunotherapy and vaccination, inpatient settings in which patients receive antibiotics, non-steroidal anti-inflammatory drugs, opiates and biological agents and operating theatres in which patients receive general anesthetics. Anaphylaxis may however develop unpredictably in any patient exposed to a wide range of drugs, food and other triggers (e.g., latex, iodinated contrast media and exercise), so it is important that all healthcare professionals and systems have effective, well-rehearsed protocols for risk assessment and management of this allergic emergency. Where available, we consider evidence for the effectiveness of interventions aiming to reduce the risk of developing anaphylaxis.

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Anaphylaxis During Radiological Procedures and in the Peri-operative Setting

Cited by 3 publications

References 126 publications

Perioperative Anaphylaxis: What Should Be Known?

Perioperative Anaphylaxis: What Should Be Known?

Feeling blue, going green and finding other attractive alternatives: a case of biphasic anaphylaxis to patent blue and a literature review of alternative sentinel node localisation methods

Prevention of anaphylaxis in healthcare settings

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