Specialist perioperative allergy clinic services in the UK 2018: Results from the Royal College of Anaesthetists Sixth National Audit Project (NAP6) investigation of perioperative anaphylaxis

Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology
W EgnerN J N Harper

Abstract

The Royal College of Anaesthetists 6th National Audit Project examined Grade 3-5 perioperative anaphylaxis for 1 year in the UK. To describe the causes and investigation of anaphylaxis in the NAP6 cohort, in relation to published guidance and previous baseline survey results. We used a secure registry to gather details of Grade 3-5 perioperative anaphylaxis. Anonymous reports were aggregated for analysis and reviewed in detail. Panel consensus diagnosis, reaction grade, review of investigations and clinic assessment are reported and compared to the prior NAP6 baseline clinic survey. A total of 266 cases met inclusion criteria between November 2015 and 2016, detailing reactions and investigations. One hundred and ninety-two of 266 (72%) had anaphylaxis with a trigger identified, of which 140/192 (75%) met NAP6 criteria for IgE-mediated allergic anaphylaxis, 13% lacking evidence of positive IgE tests were labelled "non-allergic anaphylaxis". 3% were non-IgE-mediated anaphylaxis. Adherence to guidance was similar to the baseline survey for waiting time for clinic assessment. However, lack of testing for chlorhexidine and latex, non-harmonized testing practices and poor coverage of all possible culprits was confirmed. Challenge tes...Continue Reading

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Citations

Sep 28, 2018·Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology·Susana Marinho
Feb 9, 2020·Clinical Reviews in Allergy & Immunology·Evangelia Passia, Peter Jandus
Dec 14, 2019·Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology·Graham RobertsJ A Woodfolk
Mar 23, 2021·The Journal of Allergy and Clinical Immunology. in Practice·Joana VitteMariana C Castells
Apr 17, 2021·The Journal of Allergy and Clinical Immunology. in Practice·Didier G EboVito Sabato
Mar 13, 2019·The Journal of Allergy and Clinical Immunology. in Practice·Didier G EboVito Sabato

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