Michael McLure1, Kathryn Eastwood1, Michael Parr2, Janet Bray3. 1. Monash University, Department of Epidemiology and Preventive Medicine, Australia. 2. Liverpool Hospital, Intensive Care Unit, Australia; Macquarie University Hospitals, Intensive Care Unit, Australia; University of New South Wales and Macquarie University, Australia. 3. Monash University, Department of Epidemiology and Preventive Medicine, Australia; Curtin University, Prehospital, Resuscitation and Emergency Care Research Unit, Australia. Electronic address: janet.bray@monash.edu.
Abstract
BACKGROUND: We conducted a rapid review of current international and Australian advanced life support (ALS) guidelines for cardiac arrest associated with anaphylaxis to (1) assess the variation and (2) determine if a systematic review update of ALS guideline recommendations is warranted. METHOD: A search and comparison of key recommendations was conducted for major international and Australian clinical guidelines, including member societies and councils of the World Allergy Organisation and the International Liaison Committee on Resuscitation (ILCOR). Systematic database searches (Medline, Cochrane Database of Systematic Reviews, PROSPERO international register of systematic reviews and ClinicalTrials.gov databases) was conducted to identify existing and in-progress research published on the topic of anaphylaxis and cardiac arrest. RESULTS: Eight international guidelines were identified from Australia/New Zealand, Europe, United States and Canada, and 5 national guidelines were identified for Australia. There was general consensus across all guidelines for the use of adrenaline, oxygen, patient positioning and glucagon. There was variation across international and Australian guidelines for adrenaline dosing and frequency, antihistamines and corticosteroid recommendations. Most recommendations were based on low-level evidence, and the review of published systematic reviews and clinical trials identified new evidence in the last decade. CONCLUSIONS: We found significant variation between current ALS guideline recommendations for treating anaphylaxis. While there is no new evidence to suggest a systematic review of guideline recommendations is needed, there may be an opportunity to produce more consistent international guideline recommendations and educational materials.
BACKGROUND: We conducted a rapid review of current international and Australian advanced life support (ALS) guidelines for cardiac arrest associated with anaphylaxis to (1) assess the variation and (2) determine if a systematic review update of ALS guideline recommendations is warranted. METHOD: A search and comparison of key recommendations was conducted for major international and Australian clinical guidelines, including member societies and councils of the World Allergy Organisation and the International Liaison Committee on Resuscitation (ILCOR). Systematic database searches (Medline, Cochrane Database of Systematic Reviews, PROSPERO international register of systematic reviews and ClinicalTrials.gov databases) was conducted to identify existing and in-progress research published on the topic of anaphylaxis and cardiac arrest. RESULTS: Eight international guidelines were identified from Australia/New Zealand, Europe, United States and Canada, and 5 national guidelines were identified for Australia. There was general consensus across all guidelines for the use of adrenaline, oxygen, patient positioning and glucagon. There was variation across international and Australian guidelines for adrenaline dosing and frequency, antihistamines and corticosteroid recommendations. Most recommendations were based on low-level evidence, and the review of published systematic reviews and clinical trials identified new evidence in the last decade. CONCLUSIONS: We found significant variation between current ALS guideline recommendations for treating anaphylaxis. While there is no new evidence to suggest a systematic review of guideline recommendations is needed, there may be an opportunity to produce more consistent international guideline recommendations and educational materials.
Authors: Amy Dodd; Anna Hughes; Nicholas Sargant; Andrew F Whyte; Jasmeet Soar; Paul J Turner Journal: Resuscitation Date: 2021-04-23 Impact factor: 5.262
Authors: Jean Bousquet; Ioana Agache; Hubert Blain; Marek Jutel; Maria Teresa Ventura; Margitta Worm; Stefano Del Giacco; Athanasios Benetos; Beatrice Maria Bilo; Wienczyslawa Czarlewski; Amir Hamzah Abdul Latiff; Mona Al-Ahmad; Elizabeth Angier; Isabella Annesi-Maesano; Marina Atanaskovic-Markovic; Claus Bachert; Annick Barbaud; Anna Bedbrook; Kazi S Bennoor; Elena Camelia Berghea; Carsten Bindslev-Jensen; Sergio Bonini; Sinthia Bosnic-Anticevich; Knut Brockow; Luisa Brussino; Paulo Camargos; G Walter Canonica; Victoria Cardona; Pedro Carreiro-Martins; Ana Carriazo; Thomas Casale; Jean-Christoph Caubet; Lorenzo Cecchi; Antonio Cherubini; George Christoff; Derek K Chu; Alvaro A Cruz; Dejan Dokic; Yehia El-Gamal; Motohiro Ebisawa; Bernadette Eberlein; John Farrell; Montserrat Fernandez-Rivas; Wytske J Fokkens; Joao A Fonseca; Yadong Gao; Gaëtan Gavazzi; Radoslaw Gawlik; Asli Gelincik; Bilun Gemicioğlu; Maia Gotua; Olivier Guérin; Tari Haahtela; Karin Hoffmann-Sommergruber; Hans Jürgen Hoffmann; Maja Hofmann; Martin Hrubisko; Maddalena Illario; Carla Irani; Zhanat Ispayeva; Juan Carlos Ivancevich; Kaja Julge; Igor Kaidashev; Musa Khaitov; Edward Knol; Helga Kraxner; Piotr Kuna; Violeta Kvedariene; Antti Lauerma; Lan T T Le; Vincent Le Moing; Michael Levin; Renaud Louis; Olga Lourenco; Vera Mahler; Finbarr C Martin; Andrea Matucci; Branislava Milenkovic; Stéphanie Miot; Emma Montella; Mario Morais-Almeida; Charlotte G Mortz; Joaquim Mullol; Leyla Namazova-Baranova; Hugo Neffen; Kristof Nekam; Marek Niedoszytko; Mikaëla Odemyr; Robyn E O'Hehir; Yoshitaka Okamoto; Markus Ollert; Oscar Palomares; Nikolaos G Papadopoulos; Petr Panzner; Giovanni Passalacqua; Vincenzo Patella; Mirko Petrovic; Oliver Pfaar; Nhân Pham-Thi; Davor Plavec; Todor A Popov; Marysia T Recto; Frederico S Regateiro; Jacques Reynes; Regina E Roller-Winsberger; Yves Rolland; Antonino Romano; Carmen Rondon; Menachem Rottem; Philip W Rouadi; Nathalie Salles; Boleslaw Samolinski; Alexandra F Santos; Faradiba S Sarquis; Joaquin Sastre; Jos M G A Schols; Nicola Scichilone; Anna Sediva; Mohamed H Shamji; Aziz Sheikh; Isabel Skypala; Sylwia Smolinska; Milena Sokolowska; Bernardo Sousa-Pinto; Milan Sova; Rafael Stelmach; Gunter Sturm; Charlotte Suppli Ulrik; Ana Maria Todo-Bom; Sanna Toppila-Salmi; Ioanna Tsiligianni; Maria Torres; Eva Untersmayr; Marilyn Urrutia Pereira; Arunas Valiulis; Joana Vitte; Alessandra Vultaggio; Dana Wallace; Jolanta Walusiak-Skorupa; De-Yun Wang; Susan Waserman; Arzu Yorgancioglu; Osman M Yusuf; Mario Zernotti; Mihaela Zidarn; Tomas Chivato; Cezmi A Akdis; Torsten Zuberbier; Ludger Klimek Journal: Allergy Date: 2021-10 Impact factor: 14.710