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Littlejohns A, Savic L. Management and treatment of perioperative hypersensitivity. Curr Opin Allergy Clin Immunol 2024; 24:210-217. [PMID: 38814699 DOI: 10.1097/aci.0000000000001000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
PURPOSE OF REVIEW Perioperative hypersensitivity reactions are rare but potentially catastrophic events. This review acts to summarize recent recommendations for both immediate and poststabilization management of suspected reactions, alongside practical advice for anaesthetists who may be faced with these events. RECENT FINDINGS Prompt treatment is essential but may be hampered by delay in recognition. This can occur because there are multiple differential diagnoses for the observed clinical signs as well as variations in clinical presentation. Resuscitation is dependent on the use of adrenaline and fluids. Adrenaline should be administered in small, titrated intravenous boluses. Low-dose infusions should be commenced early if the response to boluses is poor. Large volume fluid resuscitation may be required to maintain adequate circulating volume. Chest compressions are recommended when there is evidence of inadequate perfusion, rather than waiting until cardiac arrest is confirmed. Antihistamines and corticosteroids are no longer recommended in the immediate management phase. Once the patient has been stabilized, it is important to obtain serial tryptase concentrations to aid the subsequent clinic investigation. The decision to proceed or abandon surgery will be based on an individual risk-benefit analysis. All cases of suspected perioperative hypersensitivity, including fatal cases, must be referred for formal investigation. SUMMARY There have been recent updates to management guidelines in perioperative hypersensitivity. Treatment algorithms, treatment packs and referral packs can all help the anaesthetist manage these complex cases, aid the subsequent investigation and ensure patient safety in the future.
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Affiliation(s)
- Anna Littlejohns
- Anaesthetic Department, Leeds Teaching Hospitals Trust, Leeds, UK
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Kinjo R, Kojima T, Miyamoto T, Sakaguchi T, Suzuki R. A Case of Anaphylactic Shock Suspected to Be Caused by Bovine Serum Albumin Tissue Adhesive (BioGlue) During Thoracoabdominal Aortic Replacement. Cureus 2024; 16:e62678. [PMID: 39036193 PMCID: PMC11258937 DOI: 10.7759/cureus.62678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2024] [Indexed: 07/23/2024] Open
Abstract
Bovine serum albumin (BSA) tissue adhesive (BioGlue, Cryolife Inc., Kennesaw, GA, USA) is often used as a hemostatic adjunct in adult patients undergoing open surgical repair of large vessels, such as the aorta, femoral, and carotid arteries. We present a case of intraoperative anaphylaxis attributed to the use of BioGlue during thoracoabdominal aortic replacement. The patient suddenly developed hypotension, hypoxemia, and airway edema after the BioGlue application. BioGlue is composed of purified BSA and glutaraldehyde. Despite the BSA component being an allergen that can cause anaphylaxis in some patients, reported occurrences of anaphylaxis are extremely rare. We need to recognize BSA tissue adhesive as a potential allergen. In the event of an intraoperative shock, prompt recognition and investigation of the underlying cause are necessary.
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Affiliation(s)
- Rintaro Kinjo
- Cardiovascular Surgery, Japanese Red Cross Kumamoto Hospital, Kumamoto, JPN
| | - Takenori Kojima
- Cardiovascular Surgery, Japanese Red Cross Kumamoto Hospital, Kumamoto, JPN
| | - Tomoya Miyamoto
- Cardiovascular Surgery, Japanese Red Cross Kumamoto Hospital, Kumamoto, JPN
| | - Takeshi Sakaguchi
- Cardiovascular Surgery, Japanese Red Cross Kumamoto Hospital, Kumamoto, JPN
| | - Ryusuke Suzuki
- Cardiovascular Surgery, Japanese Red Cross Kumamoto Hospital, Kumamoto, JPN
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Aydemir S, Gemici Karaaslan HB, Mustu U, Tin O, Hakalmaz AE, Ozcan R, Emre S, Kendigelen P, Tutuncu AC, Kiykim A, Cokugras H. Perioperative hypersensitivity in children: A prospective multidisciplinary study. Acta Anaesthesiol Scand 2024; 68:321-327. [PMID: 37963631 DOI: 10.1111/aas.14354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/10/2023] [Accepted: 10/23/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND There are few studies of perioperative hypersensitivity reactions in children. The diagnosis of perioperative hypersensitivity reactions may be under estimated because it is difficult to recognize the reactions. Anaphylaxis may go unnoticed because of patient unconsciousness. Urticaria may be missed due to sterile drapes. The aim of this study was to prospectively evaluate perioperative hypersensitivity reactions. METHODS In this prospective study, patients with suspected perioperative hypersensitivity reactions aged 0-18 years who underwent surgery at the Department of Pediatric Surgery, Cerrahpasa Faculty of Medicine, between 2019 and 2021 were investigated. Suspected reactions in the perioperative period were graded according to the Ring and Messmer scale. Patients with suspected reactions were examined 4-6 weeks after the reaction. If necessary, specific IgE and basophil activation tests were performed. Reactions of grades III-IV were considered anaphylaxis. If one test modality was strongly positive and there was a relevant time point or repeated allergic reactions, or at least two test modalities were positive, hypersensitivity was confirmed. In all patients, serum tryptase levels were analyzed at the time of the reaction, 2 h after the reaction, and 4-6 weeks after the reaction as part of the allergic evaluation. RESULTS A total of 29 patients (8 female, 21 male) suspected of having an intraoperative reaction during the study were included in the analysis. Perioperative hypersensitivity reactions were noted in 1 patient. The incidence of perioperative hypersensitivity reactions was reported to be 0.03% (n = 1/2861). While anaphylaxis was confirmed in 1 patient, 5 patients were considered possible anaphylaxis cases. CONCLUSION Perioperative hypersensitivity reactions can be life-threatening and may recur with further administration. Collaboration between pediatric surgeons, anesthesiologists, and allergists can prevent further reactions. All suspected cases should be evaluated by an experienced allergist soon after the initial reaction.
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Affiliation(s)
- Sezin Aydemir
- Department of Pediatric Allergy and Immunology, Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Hatice Betul Gemici Karaaslan
- Department of Pediatric Allergy and Immunology, Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ulviye Mustu
- Department of Pediatric Allergy and Immunology, Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Oguzhan Tin
- Department of Pediatrics, Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ali Ekber Hakalmaz
- Department of Pediatric Surgery, Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Rahsan Ozcan
- Department of Pediatric Surgery, Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Senol Emre
- Department of Pediatric Surgery, Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Pinar Kendigelen
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ayse Cigdem Tutuncu
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ayca Kiykim
- Department of Pediatric Allergy and Immunology, Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Haluk Cokugras
- Department of Pediatric Allergy and Immunology, Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
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Chow KL, Patchett K, Reeves G, de Malmanche T, Gillies D, Boyle M. Morphine-specific IgE testing in the assessment of neuromuscular blocking agent allergy: a single centre experience. Br J Anaesth 2024; 132:193-195. [PMID: 37945415 DOI: 10.1016/j.bja.2023.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/26/2023] [Accepted: 10/09/2023] [Indexed: 11/12/2023] Open
Affiliation(s)
- Ke L Chow
- Department of Immunology, NSW Health Pathology, Newcastle, NSW, Australia.
| | - Kathryn Patchett
- Department of Immunology, NSW Health Pathology, Newcastle, NSW, Australia
| | - Glenn Reeves
- Department of Immunology, NSW Health Pathology, Newcastle, NSW, Australia; Department of Immunology, John Hunter Hospital, Newcastle, NSW, Australia; School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Theo de Malmanche
- Department of Immunology, NSW Health Pathology, Newcastle, NSW, Australia; School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Donna Gillies
- Medical and Interventional Services, John Hunter Hospital, Newcastle, NSW, Australia
| | - Michael Boyle
- Department of Immunology, John Hunter Hospital, Newcastle, NSW, Australia; School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
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Joaquim J, Matos C, Mateos-Campos R. Iopromide safety assessment in a radiology department: A seven-year retrospective characterization of adverse events. INTERNATIONAL JOURNAL OF RISK & SAFETY IN MEDICINE 2024; 35:117-129. [PMID: 37807788 DOI: 10.3233/jrs-230021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
BACKGROUND Since the mid-20th century, contrast agents have been widely used in radiology due to their ability to provide high-definition radiographic images and greater precision in diagnostic exams. Different types of contrast agents are used in image diagnosis, namely radiological media. Despite being considered safe, there are still uncertainties about their safety profile, interactions, and incidence of adverse drug reactions in real-world settings. OBJECTIVE To characterise the pattern of adverse events, during 7 years, in a radiology unit. METHODS We performed a retrospective observational and descriptive study at an Image Center in Portugal between August 2012 and October 2019. A total of 77,449 computed tomography (CT) were registered, and from those 15,640 cases of iopromide were used as a contrast agent. The authors have accessed, under the authorization, the data of adverse events and procedures after the event. RESULTS Most of the hypersensitivity events were immediate or with a short time of onset, with the majority of cases developing events with skin involvement and mild degree, where the most common events were papules (n = 60), pruritus (n = 42), erythema (n = 27) and urticaria (n = 14). Severe events, including hypersensitivity, were mainly represented by vomiting (n = 11), stridor (n = 8), breathing difficulties (n = 7) and syncope (n = 3). Abdominal-pelvic CT exam presented a higher frequency of adverse events. CONCLUSION Despite all the current information about iopromide usage, the utilization of this agent is not abstent of risks and its safety profile not fully established. Most frequent symptoms were local, as skin adverse events, including papules, pruritus and erythema. Common medications used to treat or control adverse events were frequently hydrocortisone, clemastine and methylprednisolone.
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Affiliation(s)
- João Joaquim
- Polytechnic Institute of Coimbra, Coimbra Health School, Coimbra, Portugal
- Department of Pharmaceutical Sciences, Pharmacy Faculty, University of Salamanca (USAL), Salamanca, Spain
| | - Cristiano Matos
- Polytechnic Institute of Coimbra, Coimbra Health School, Coimbra, Portugal
| | - Ramona Mateos-Campos
- Area of Preventive Medicine and Public Health, Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain
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Maamari JA, Wolfe RC. Perioperative Management of Local Anesthetic Allergies. J Perianesth Nurs 2023; 38:947-949. [PMID: 37865905 DOI: 10.1016/j.jopan.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 09/05/2023] [Indexed: 10/23/2023]
Affiliation(s)
- Julie A Maamari
- Department of Pharmacy, Barnes-Jewish Hospital, St. Louis, MO
| | - Rachel C Wolfe
- Department of Pharmacy, Barnes-Jewish Hospital, St. Louis, MO.
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Hubbard JA, Wolfe RC. Perioperative Considerations in Patients With Mast Cell Activation Syndrome. J Perianesth Nurs 2023; 38:357-360. [PMID: 36828701 DOI: 10.1016/j.jopan.2023.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 01/07/2023] [Indexed: 02/25/2023]
Affiliation(s)
- Julie A Hubbard
- Department of Pharmacy, Barnes-Jewish Hospital, St. Louis, MO
| | - Rachel C Wolfe
- Department of Pharmacy, Barnes-Jewish Hospital, St. Louis, MO.
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Wang K, Gartman CH, Zhou EY, Horak J, Augoustides JG, Gebhardt BR, Jain A, Coleman SR, Fernando RJ. Severe Bronchospasm During Separation from Cardiopulmonary Bypass: Diagnosis, Etiology, and Treatment. J Cardiothorac Vasc Anesth 2022; 36:3964-3972. [PMID: 35909041 DOI: 10.1053/j.jvca.2022.06.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 06/20/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Kelvin Wang
- Cardiovascular and Thoracic Division, Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Charles H Gartman
- Cardiovascular and Thoracic Division, Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Elizabeth Yaxi Zhou
- Cardiovascular and Thoracic Division, Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jiri Horak
- Cardiovascular and Thoracic Division, Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - John G Augoustides
- Cardiovascular and Thoracic Division, Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Brian R Gebhardt
- Department of Anesthesiology and Perioperative Medicine, University of Massachusetts Medical Center, Worcester, MA, USA
| | - Ankit Jain
- Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Scott R Coleman
- Department of Anesthesiology, Cardiothoracic Section, Medical Center Boulevard, Wake Forest School of Medicine, Winston Salem, NC 27157-1009, USA
| | - Rohesh J Fernando
- Department of Anesthesiology, Cardiothoracic Section, Medical Center Boulevard, Wake Forest School of Medicine, Winston Salem, NC 27157-1009, USA.
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Chida K, Ishido K, Sakamoto Y, Kimura N, Morohashi H, Miura T, Wakiya T, Yokoyama H, Nagase H, Ichinohe D, Suto A, Kuwata D, Ichisawa A, Nakamura A, Kasai D, Hakamada K. Necrotizing pancreatitis complicated by retroperitoneal emphysema: two case reports. Surg Case Rep 2022; 8:183. [PMID: 36163599 PMCID: PMC9512950 DOI: 10.1186/s40792-022-01542-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 09/22/2022] [Indexed: 12/02/2022] Open
Abstract
Background Emphysematous pancreatitis is acute pancreatitis associated with emphysema based on imaging studies and has been considered a subtype of necrotizing pancreatitis. Although some recent studies have reported the successful use of conservative treatment, it is still considered a serious condition. Computed tomography (CT) scan is useful in identifying emphysema associated with acute pancreatitis; however, whether the presence of emphysema correlates with the severity of pancreatitis remains controversial. In this study, we managed two cases of severe acute pancreatitis complicated with retroperitoneal emphysema successfully by treatment with lavage and drainage. Case presentation Case 1: A 76-year-old man was referred to our hospital after being diagnosed with acute pancreatitis. At post-admission, his abdominal symptoms worsened, and a repeat CT scan revealed increased retroperitoneal gas. Due to the high risk for gastrointestinal tract perforation, emergent laparotomy was performed. Fat necrosis was observed on the anterior surface of the pancreas, and a diagnosis of acute necrotizing pancreatitis with retroperitoneal emphysema was made. Thus, retroperitoneal drainage was performed. Case 2: A 50-year-old woman developed anaphylactic shock during the induction of general anesthesia for lumbar spine surgery, and peritoneal irritation symptoms and hypotension occurred on the same day. Contrast-enhanced CT scan showed necrotic changes in the pancreatic body and emphysema surrounding the pancreas. Therefore, she was diagnosed with acute necrotizing pancreatitis with retroperitoneal emphysema, and retroperitoneal cavity lavage and drainage were performed. In the second case, the intraperitoneal abscess occurred postoperatively, requiring time for drainage treatment. Both patients showed no significant postoperative course problems and were discharged on postoperative days 18 and 108, respectively. Conclusion Acute pancreatitis with emphysema from the acute phase highly indicates severe necrotizing pancreatitis. Surgical drainage should be chosen without hesitation in necrotizing pancreatitis with emphysema from early onset.
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Ritter S, Bowden J, Pattanaik D. A case of perioperative anaphylaxis presenting as hereditary alpha tryptasemia. Ann Allergy Asthma Immunol 2022; 129:13-16. [PMID: 35292365 DOI: 10.1016/j.anai.2022.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 10/18/2022]
Affiliation(s)
- Shaunah Ritter
- Division of Allergy and Immunology, Le Bonheur Children's Medical Center, The University of Tennessee Health Sciences Center, Memphis, Tennessee.
| | - Jarred Bowden
- Department of Pharmacy, VA Medical Center, Memphis, Tennessee
| | - Debendra Pattanaik
- Section of Allergy and Immunology, VA Medical Center, The University of Tennessee Health Sciences Center, Memphis, Tennessee
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Murakami Y, Kaneko S, Yokoyama H, Ishizaki H, Sekino M, Murata H, Hara T. Successful treatment of severe adrenaline-resistant anaphylactic shock with glucagon in a patient taking a beta-blocker: a case report. JA Clin Rep 2021; 7:86. [PMID: 34907487 PMCID: PMC8671579 DOI: 10.1186/s40981-021-00490-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 11/29/2021] [Accepted: 12/04/2021] [Indexed: 01/19/2023] Open
Abstract
Background The efficacy of glucagon for adrenaline-resistant anaphylactic shock in patients taking β-blockers is controversial. However, understanding the efficacy of glucagon is important because adrenaline-resistant anaphylactic shock is fatal. We present a case of severe adrenaline-resistant anaphylactic shock in a patient taking a β-blocker, and glucagon was effective in improving hemodynamics. Case presentation An 88-year-old woman with severe aortic stenosis and taking a selective β-1 blocker underwent transcatheter aortic valve implantation under general anesthesia. Postoperatively, she received 100 mg sugammadex, but 2 min later developed severe hypotension and bronchospasm. Suspecting anaphylactic shock, we intervened by administering adrenaline, fluid loading, and an increased noradrenaline dose. Consequently, the bronchospasm improved, but her blood pressure only increased minimally. Therefore, we administered 1 mg glucagon intravenously, and the hypotension resolved immediately. Conclusions Glucagon may improve hemodynamics in adrenaline-resistant anaphylactic shock patients taking β-blockers; however, its efficacy must be further evaluated in more cases.
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Affiliation(s)
- Yu Murakami
- Department of Anesthesiology and Intensive Care Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Shohei Kaneko
- Department of Anesthesiology and Intensive Care Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
| | - Haruka Yokoyama
- Department of Anesthesiology and Intensive Care Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Hironori Ishizaki
- Department of Anesthesiology and Intensive Care Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Motohiro Sekino
- Department of Anesthesiology and Intensive Care Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Hiroaki Murata
- Department of Anesthesiology and Intensive Care Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Tetsuya Hara
- Department of Anesthesiology and Intensive Care Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
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Abstract
PURPOSE OF REVIEW Ambulatory surgery is increasing, more procedures as well as more complex procedures are transferred to ambulatory surgery. Patients of all ages including elderly and more fragile are nowadays scheduled for ambulatory surgery. Enhanced recovery after surgery (ERAS) protocols are now developed for further facilitating readily recovery, ambulation, and discharge. Thus, to secure safety, a vigilant planning and preparedness for adverse events and emergencies is mandatory. RECENT FINDINGS Proper preoperative assessment, preparation/optimization and collaboration between anaesthetist and surgeon to plan for the optimal perioperative handling has become basic to facilitate well tolerated perioperative course. Standard operating procedures for rare emergencies must be in place. These SOPs should be trained and retrained on a regular basis to secure safety. Check lists and cognitive aids are tools to help improving safety. Audit and analysis of adverse outcomes and deviations is likewise of importance to continuously analyse and implement corrective activity plans whenever needed. SUMMARY The present review will provide an oversight of aspects that needs to be acknowledged around planning handling of rare but serious emergencies to secure quality and safety of care in freestanding ambulatory settings.
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Affiliation(s)
- Elin Karlsson
- Department of Anaesthesia & Intensive Care, Institution for Clinical Sciences, Karolinska Institutet at Danderyds University Hospital, Stockholm, Sweden
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Luo J, Chen Q, Min S, Yu J. Perioperative Anaphylaxis from a Perspective of Temperature. J INVEST SURG 2021; 35:833-840. [PMID: 33998366 DOI: 10.1080/08941939.2021.1922553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Perioperative anaphylaxis poses a special challenge due to its unique condition with the additive effects of surgery and anesthesia, which tends to be more difficult to recognize, diagnose, and manage, resulting in potentially fatal outcomes. Appropriate prevention and treatment benefits patients and reduces mortality and morbidity. Significant body temperature changes occur during anaphylaxis and/or anesthesia, which correlates with the outcomes. During the perioperative period, body temperature and anaphylaxis bidirectionally interact with each other, and anaphylaxis is generally deteriorated by hypothermia, which is usually required in cardiac surgeries. Perioperative factors, such as surgery and anesthesia, affect body temperature and anaphylaxis. The complicated role of body temperature and its application in the diagnosis of perioperative anaphylaxis and prediction of the outcomes are still unclear. To date, a profile of body temperature change during perioperative anaphylaxis is lacking, which requires further study. This literature review was conducted with updated data on perioperative anaphylaxis from the perspective of temperature as a component aiming to bring attention to and offer some cues for improving perioperative prevention and management for perioperative medical teams.Supplemental data for this article is available online at https://doi.org/10.1080/08941939.2021.1922553 .
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Affiliation(s)
- Jie Luo
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qibin Chen
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Su Min
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jian Yu
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Tucker PK, Macfarlane P. Severe bronchoconstriction as part of a suspected anaphylactic reaction in a dog following administration of gadobutrol. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2019-001051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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