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Practice Guideline
. 2022 Feb;77(2):357-377.
doi: 10.1111/all.15032. Epub 2021 Sep 1.

EAACI guidelines: Anaphylaxis (2021 update)

Antonella Muraro  1 , Margitta Worm  2 , Cherry Alviani  3 , Victoria Cardona  4 , Audrey DunnGalvin  5   6 , Lene Heise Garvey  7   8 , Carmen Riggioni  9 , Debra de Silva  10 , Elizabeth Angier  11 , Stefania Arasi  12 , Abdelouahab Bellou  13   14   15 , Kirsten Beyer  16 , Diola Bijlhout  17 , Maria Beatrice Bilò  18   19 , Carsten Bindslev-Jensen  20 , Knut Brockow  21 , Montserrat Fernandez-Rivas  22 , Susanne Halken  23 , Britt Jensen  20 , Ekaterina Khaleva  3 , Louise J Michaelis  24   25 , Hanneke N G Oude Elberink  26 , Lynne Regent  27 , Angel Sanchez  28 , Berber J Vlieg-Boerstra  29 , Graham Roberts  3   30   31 ; European Academy of Allergy and Clinical Immunology, Food Allergy, Anaphylaxis Guidelines Group
Affiliations
Practice Guideline

EAACI guidelines: Anaphylaxis (2021 update)

Antonella Muraro et al. Allergy. 2022 Feb.

Abstract

Anaphylaxis is a clinical emergency which all healthcare professionals need to be able to recognize and manage. The European Academy of Allergy and Clinical Immunology Anaphylaxis multidisciplinary Task Force has updated the 2014 guideline. The guideline was developed using the AGREE II framework and the GRADE approach. The evidence was systematically reviewed and recommendations were created by weighing up benefits and harms. The guideline was peer-reviewed by external experts and reviewed in a public consultation. The use of clinical criteria to identify anaphylaxis is suggested with blood sampling for the later measurement of tryptase. The prompt use of intramuscular adrenaline as first-line management is recommended with the availability of adrenaline autoinjectors to patients in the community. Pharmacokinetic data should be provided for adrenaline autoinjector devices. Structured, comprehensive training for people at risk of anaphylaxis is recommended. Simulation training and visual prompts for healthcare professionals are suggested to improve the management of anaphylaxis. It is suggested that school policies reflect anaphylaxis guidelines. The evidence for the management of anaphylaxis remains mostly at a very low level. There is an urgent need to prioritize clinical trials with the potential to improve the management of patients at risk of anaphylaxis.

Keywords: adults; anaphylaxis; children; guidelines.

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References

REFERENCES

    1. Simons FE, Ardusso LR, Bilo MB, et al. International consensus on (ICON) anaphylaxis. World Allergy Organ J. 2014;7(1):9.
    1. Bilo MB, Corsi A, Martini M, Penza E, Grippo F, Bignardi D. Fatal anaphylaxis in Italy: analysis of cause-of-death national data, 2004-2016. Allergy. 2020;75(10):2644-2652.
    1. Turner PJ, Gowland MH, Sharma V, et al. Increase in anaphylaxis-related hospitalizations but no increase in fatalities: an analysis of United Kingdom national anaphylaxis data, 1992-2012. J Allergy Clin Immunol. 2015;135(4):956-963.e1.
    1. Greenhawt M, Gupta RS, Meadows JA, et al. Guiding principles for the recognition, diagnosis, and management of infants with anaphylaxis: an expert panel consensus. J Allergy Clin Immunol Pract 2019;7(4):1148-1156 e1145.
    1. Francuzik W, Ruëff F, Bauer A, et al. Phenotype and risk factors of venom-induced anaphylaxis: a case-control study of the European Anaphylaxis Registry. J Allergy Clin Immunol. 2021;147(2):653-662.e9. https://doi.org/10.1016/j.jaci.2020.06.008. Epub 2020 Jun 22.

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