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Title
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Medical algorithms : diagnosis and investigation of perioperative immediate hypersensitivity reactions
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Author
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Abstract
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| A systematic approach to both diagnosis and investigations is essential, when investigating a patient with a suspected perioperative hypersensitivity reaction. The perioperative setting is extremely complex with documented and undocumented exposures to many different drugs and substances. In addition, the effect of anaesthetic drugs and surgical procedure may mimic hypersensitivity. To ensure that all these complexities are addressed, collaboration between allergist and anaesthetist is essential. Also, the current recommendation is, that investigation of these patients should take place in highly specialized centres or in centres investigating a minimum of 20 patients/year, and where close collaboration between allergists and anaesthetists is established.1 Such collaborations have been endorsed in the recent 6th British National Audit Project (NAP6),2 and in recent publications from European and international working groups making recommendations on the management and investigation of perioperative hypersensitivity reactions.1, 3 In the following, two algorithms are presented based on recent recommendations1-7: Algorithm 1 shows an approach to gathering the complete and correct information, deciding on whether perioperative hypersensitivity is likely and identifying the relevant potential culprits to investigate. Algorithm 2 presents an approach to which investigations should be performed, how to assess causality for individual drugs and how to reach final conclusions. |
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Language
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English
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Source (journal)
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Allergy: European journal of allergy and clinical immunology. - Copenhagen
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Publication
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Hoboken
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Wiley
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2020
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ISSN
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0105-4538
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DOI
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10.1111/ALL.14226
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Volume/pages
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75
:8
(2020)
, p. 2139-2142
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Article Reference
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all.14226
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ISI
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000520814200001
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Pubmed ID
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32053736
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Medium
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E-only publicatie
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Full text (Publisher's DOI)
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Full text (open access)
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Full text (publisher's version - intranet only)
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