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Clinical evaluation of pediatric anaphylaxis and the necessity for multiple doses of epinephrine

BACKGROUND: Epinephrine administered intramuscularly is the treatment of choice for anaphylaxis, and more than 1 dose is occasionally required. OBJECTIVE: To determine clinical background of anaphylaxis for improving the treatment, management, and prognosis of anaphylaxis. METHODS: Children who had...

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Autores principales: Inoue, Naoyuki, Yamamoto, Asuka
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Asia Pacific Association of Allergy, Asthma and Clinical Immunology 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3643057/
https://www.ncbi.nlm.nih.gov/pubmed/23667834
http://dx.doi.org/10.5415/apallergy.2013.3.2.106
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author Inoue, Naoyuki
Yamamoto, Asuka
author_facet Inoue, Naoyuki
Yamamoto, Asuka
author_sort Inoue, Naoyuki
collection PubMed
description BACKGROUND: Epinephrine administered intramuscularly is the treatment of choice for anaphylaxis, and more than 1 dose is occasionally required. OBJECTIVE: To determine clinical background of anaphylaxis for improving the treatment, management, and prognosis of anaphylaxis. METHODS: Children who had satisfied the diagnostic criteria for anaphylaxis according to the National Institute of Allergy and Infectious Disease Food Allergy and Anaphylaxis Network were selected from our hospital from April 1, 2009 to March 31, 2012. RESULTS: We analyzed 61 patients from the ages of 2 months to 14 years who satisfied the diagnostic criteria for anaphylaxis. Parents of 32 children (52.5%) reported that they had been administered single dose of epinephrine, and 3 children (4.9%) reported receiving multiple doses of epinephrine. The latter group experienced syncope more often (p = 0.049) than the former and suffered more often from comorbid allergic diseases (p = 0.043) that included either bronchial asthma, allergic rhinitis, or atopic dermatitis. Two (3.3%) children experienced biphasic reactions. Patients who experienced a biphasic reaction were more likely to have experienced syncope (p = 0.033), vomiting (p = 0.02), and administration of multiple doses of epinephrine (p = 0.0016). CONCLUSION: Our findings lead us to recommend that children receiving more than 1 injection of epinephrine should be observed for 24 hours, because it seems that children with requiring more than 1 injection of epinephrine might be have biphasic reactions.
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spelling pubmed-36430572013-05-10 Clinical evaluation of pediatric anaphylaxis and the necessity for multiple doses of epinephrine Inoue, Naoyuki Yamamoto, Asuka Asia Pac Allergy Original Article BACKGROUND: Epinephrine administered intramuscularly is the treatment of choice for anaphylaxis, and more than 1 dose is occasionally required. OBJECTIVE: To determine clinical background of anaphylaxis for improving the treatment, management, and prognosis of anaphylaxis. METHODS: Children who had satisfied the diagnostic criteria for anaphylaxis according to the National Institute of Allergy and Infectious Disease Food Allergy and Anaphylaxis Network were selected from our hospital from April 1, 2009 to March 31, 2012. RESULTS: We analyzed 61 patients from the ages of 2 months to 14 years who satisfied the diagnostic criteria for anaphylaxis. Parents of 32 children (52.5%) reported that they had been administered single dose of epinephrine, and 3 children (4.9%) reported receiving multiple doses of epinephrine. The latter group experienced syncope more often (p = 0.049) than the former and suffered more often from comorbid allergic diseases (p = 0.043) that included either bronchial asthma, allergic rhinitis, or atopic dermatitis. Two (3.3%) children experienced biphasic reactions. Patients who experienced a biphasic reaction were more likely to have experienced syncope (p = 0.033), vomiting (p = 0.02), and administration of multiple doses of epinephrine (p = 0.0016). CONCLUSION: Our findings lead us to recommend that children receiving more than 1 injection of epinephrine should be observed for 24 hours, because it seems that children with requiring more than 1 injection of epinephrine might be have biphasic reactions. Asia Pacific Association of Allergy, Asthma and Clinical Immunology 2013-04 2013-04-26 /pmc/articles/PMC3643057/ /pubmed/23667834 http://dx.doi.org/10.5415/apallergy.2013.3.2.106 Text en Copyright © 2013. Asia Pacific Association of Allergy, Asthma and Clinical Immunology. http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Inoue, Naoyuki
Yamamoto, Asuka
Clinical evaluation of pediatric anaphylaxis and the necessity for multiple doses of epinephrine
title Clinical evaluation of pediatric anaphylaxis and the necessity for multiple doses of epinephrine
title_full Clinical evaluation of pediatric anaphylaxis and the necessity for multiple doses of epinephrine
title_fullStr Clinical evaluation of pediatric anaphylaxis and the necessity for multiple doses of epinephrine
title_full_unstemmed Clinical evaluation of pediatric anaphylaxis and the necessity for multiple doses of epinephrine
title_short Clinical evaluation of pediatric anaphylaxis and the necessity for multiple doses of epinephrine
title_sort clinical evaluation of pediatric anaphylaxis and the necessity for multiple doses of epinephrine
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3643057/
https://www.ncbi.nlm.nih.gov/pubmed/23667834
http://dx.doi.org/10.5415/apallergy.2013.3.2.106
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