Should adrenaline be used in patients with hemodynamically stable anaphylaxis? Incident case control study nested within a retrospective cohort study

Scientific Reports
Byuk Sung KoDavid W Bates

Abstract

Although adrenaline (epinephrine) is a cornerstone of initial anaphylaxis treatment, it is not often used. We sought to assess whether use of adrenaline in hemodynamically stable patients with anaphylaxis could prevent the development of hypotension. We conducted a retrospective cohort study of 761 adult patients with anaphylaxis presenting to the emergency department (ED) of a tertiary care hospital over a 10-year period. We divided the patients into two groups according to the occurrence of hypotension and compared demographic characteristics, clinical features, treatments and outcomes. Of the 340 patients with anaphylaxis who were normotensive at first presentation, 40 patients experienced hypotension during their ED stay. The ED stay of the hypotension group was significantly longer than that of patients who did not experience hypotension (496 min vs 253 min, P = 0.000). Adrenaline use in hemodynamically stable anaphylaxis patient was independently associated with a lower risk of developing in-hospital occurrence of hypotension: OR, 0.254 [95% CI, 0.091-0.706]. Adrenaline use in hemodynamically stable anaphylaxis patients was associated with a reduced risk of developing in-hospital occurrence of hypotension. Adverse events ...Continue Reading

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Aug 10, 2017·International Archives of Allergy and Immunology·Victòria CardonaUNKNOWN AdreSCAIC Research Group
Sep 6, 2020·The Journal of Allergy and Clinical Immunology. in Practice·Paul J TurnerRobert J Boyle
Jan 16, 2021·CJEM·Caitlin PrendergastUNKNOWN Pediatric Emergency Research Canada (PERC) Team
Apr 26, 2021·Resuscitation·Amy DoddPaul J Turner

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Anaphylaxis

Anaphylaxis is a serious allergic reaction that is rapid in onset and may cause death.