Investigation of the clinical characteristics and interventions for drug-induced anaphylaxis in the emergency infusion room
10.3760/cma.j.cn114015-20240509-00323
- VernacularTitle:急诊输液室严重药物过敏反应的临床特点及干预措施调查
- Author:
Qifang SHI
1
;
Gen BA
;
Meng LI
;
Weiwen HAO
;
Hao SUN
;
Guiping JIANG
;
Ying ZHOU
;
Huazhong ZHANG
;
Jinfu WAN
;
Jie QIAO
;
Hua JIN
;
Min XIE
;
Yun CAO
;
Juan ZHOU
;
Chao ZHAO
;
Zihao WANG
;
Jinsong ZHANG
Author Information
1. 南京医科大学第一附属医院急诊医学中心，南京 210029
- Publication Type:Journal Article
- Keywords:
Emergency treatment;
Infusions, intravenous;
Drug-related side effects and adverse reactions;
Epinephrine;
Anaphylaxis
- From:
Adverse Drug Reactions Journal
2024;26(12):715-719
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical characteristics and interventions associated with drug-induced anaphylaxis in the emergency infusion room.Methods:Bases on the adverse drug reaction database from the emergency medicine center of the First Affiliated Hospital of Nanjing Medical University, clinical data of patients who experienced drug-induced anaphylaxis in the emergency infusion room between November 2019 and November 2023 were collected, including gender, age, history of previous adverse drug reactions, allergy history, Charlson comorbidity index, medication details, information related to drug-induced anaphylaxis (onset time, clinical manifestations), interventions, outcomes, and follow-up. The clinical characteristics and interventions in these patients were analyzed.Results:During the study period, a total of 398 772 patients in the emergency infusion room in our hospital received intravenous infusion of drugs. Of them, 625 cases developed adverse drug reactions (ADRs) and 75 cases developed drug-induced anaphylaxis, accounting for 0.02% (75/398 772) of the total infusion patients and 12.0% (75/625) of all ADR cases. Of the 75 patients with anaphylaxis, 30 cases (40%) were classified as grade Ⅱ, and 45 cases (60%) as grade Ⅲ, with no grade Ⅳ cases. The most common drugs involved in 75 cases of anaphylaxis were anti-infective drugs (41 cases, 54.7%). Drug-induced anaphylaxis exhibited diverse clinical manifestations, with cardiovascular symptoms being the most common, primarily varying degrees of transient hypotension (67 cases, 89.3%), followed by systemic and neurological symptoms, including profuse sweating (31 cases, 41.3%) and dizziness (28 cases, 37.3%). All 75 patients with anaphylaxis were treated with measures such as discontinuation of medication, replacement of infusion sets, rapid assessment of circulation and respiration, and monitoring of vital signs, of which 65 (86.7%) received rapid intravenous infusion for volume expansion, 6 (8.0%) received intravenous injection of glucocorticoids, 3 (4.0%) received intramuscular injection of 0.5 mg epinephrine, and 2 (2.7%) received antihistamines. All 75 patients showed improvement in symptoms, and no sequelae or deaths were found.Conclusions:In the emergency infusion room, the severity of anaphylaxis is mainly grade Ⅱ and Ⅲ with a good prognosis after timely intervention. The treatment measures mainly focus on rapid intravenous infusion for volume expansion, and the use of epinephrine is relatively low.
