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Bagaimana untuk memprediksi reaksi alergi biphasic pada anak-anak
Alat prognostik baru
Date:
June 22, 2015
Source:
Children's Hospital of Eastern Ontario Research Institute
Summary:
Anak-anak lebih mungkin untuk mengulang , tertundanya reaksi anafilaksis dari penyebab alergi yang sama , tergantung pada tingkat keparahan reaksi awal , laporan pertama penelitian pediatric yang melihat prediktor untuk fenomena ini .
............. Sebuah penelitian yang dipimpin di Rumah Sakit Anak Eastern Ontario ( CHEO ) Research Institute memandang frekuensi dan tingkat keparahan reaksi alergi biphasic . Dari ukuran sampel dari 484 catatan pasien , kejadian reaksi biphasic terjadi pada 15 persen dari populasi penelitian , dan dua-pertiga terjadi dalam waktu enam jam dari awal reaksi awal . Setidaknya setengah dari reaksi biphasic serius di lingkungan , dan diperlukan pengobatan dengan epinefrin .....more
How to predict
biphasic allergic reactions in children
New prognostic tools
Date:
June 22, 2015
Source:
Children's Hospital of Eastern Ontario Research Institute
Summary:
Children are more likely to have a repeat, delayed anaphylactic reaction
from the same allergic cause, depending on the severity of the initial
reaction, reports the first pediatric study to look at the predictors for this
phenomenon.
...................
Children are more likely to have a repeat, delayed anaphylactic reaction
from the same allergic cause, depending on the severity of the initial
reaction. The first pediatric study to look at the predictors for this
phenomenon was published today inAnnals of Allergy, Asthma & Immunology.
Anaphylaxis is a severe, allergic reaction that is rapid in onset and can
result in death. Some children are at risk of delayed ('biphasic') anaphylactic
reactions. Delayed reactions occur when the initial symptoms of allergic
reaction go away but then return hours or days later without exposure to the initial
substance that caused the reaction.
A study led at the Children's Hospital of Eastern Ontario (CHEO) Research
Institute looked at the frequency and severity of biphasic allergic reactions.
From a sample size of 484 patient records, the incidence of biphasic reaction
occurred in 15 percent of the study population, and two thirds occurred within
six hours from the onset of the initial reaction. At least half of the biphasic
reactions were serious in nature, and required treatment with epinephrine.
The study unveiled that biphasic reactions were more likely to happen if
the initial allergic reaction was severe or if it was not treated with
epinephrine. Furthermore, the anaphylaxis tended to be more severe when the
administration of epinephrine was delayed.
'The key message here for patients, parents, caregivers, teachers, and
first-responder health professionals is: to prevent an anaphylactic reaction
from worsening, administer epinephrine immediately after the onset of the early
symptoms of an allergic reaction,' said Dr. Waleed Alqurashi, emergency
medicine physician at CHEO, and assistant professor at the University of
Ottawa. 'Our team has created an evidence-based prognostic tool so that
physicians can monitor the more serious cases appropriately.'
The team identified five independent, evidence-based predictors of biphasic
reactions in children, including:
- Delay
in presentation to the Emergency Department (or delay in epinephrine
administration) of more than 90-minutes from the onset of the initial allergic
reaction
- Wide
pulse pressure at triage
- Treatment
of the initial allergic reaction with more than one dose of epinephrine
- Respiratory
distress that requires administration of inhaled salbutamol in the
Emergency Department
- Children
between the ages of 6 to 9 years old
'It's clear that children with severe initial reactions would benefit from
a prolonged period of observation in the Emergency Department,' continued
Alqurashi. 'On the flip side, knowing what to look for helps to better utilize
resources so that children with mild allergic reaction, who do not match any of
the identified predictors can go home faster.'
The study entitled, 'Epidemiology and clinical predictors of biphasic
reactions in children with anaphylaxis' includes clinical investigators and
epidemiologists from the CHEO Research Institute, the Ottawa Hospital Research
Institute, University of Ottawa, and Memorial University.
Researchers reviewed health records of patients who presented to the
Emergency Department with anaphylaxis at CHEO and the Hospital for Sick
Children (SickKids) based on the established diagnostic criteria of the
National Institute of Allergy and infectious Diseases and the Food Allergy and
Anaphylaxis Network.
Story Source:
The above post is reprinted from materials provided byChildren's
Hospital of Eastern Ontario Research Institute.Note: Materials
may be edited for content and length.
Journal Reference:
1.
Waleed Alqurashi, MD, MSc et al. Epidemiology and clinical
predictors of biphasic reactions in children with anaphylaxis. Annals
of Allergy, Asthma & Immunology, June 2015 DOI: 10.1016/j.anai.2015.05.013