alexa Biphasic anaphylactic reactions in pediatrics.
Oncology

Oncology

Journal of Cancer Clinical Trials

Author(s): Lee JM, Greenes DS

Abstract Share this page

Abstract OBJECTIVES: The objectives of this study were to: 1) determine the incidence of biphasic reactions in children with anaphylaxis; 2) establish what risk factors can predict progression to a biphasic reaction; and 3) assess the utility of inpatient observation for patients whose anaphylaxis appears to have resolved. METHODS: We performed a retrospective analysis of all children admitted to Children's Hospital inpatient service between 1985 and 1999 with acute anaphylaxis. Data were collected from the medical records regarding past medical history, presenting signs and symptoms, treatment, and hospital course. Patients were considered to have resolution of anaphylaxis if they were documented to have cessation of all symptoms and needed no therapy for at least 1 hour. Biphasic reactions were defined as a worsening of symptoms requiring new therapy after resolution of anaphylaxis. Significant biphasic reactions were defined as those requiring oxygen, vasopressors, intubation, subcutaneous epinephrine, or unscheduled bronchodilator treatments. Patients were considered to benefit from a 24-hour observation period if they had a significant biphasic reaction within 24 hours of admission. RESULTS: Of 108 anaphylactic episodes, 2 (2\%) were fatal, and 1 (1\%) was a protracted anaphylactic reaction. Among the remaining 105 children with resolution of anaphylaxis, 6 (6\%) [95\% confidence (CI): 2, 12] had biphasic reactions, of which 3 (3\%) [95\% CI:.6, 8] were significant. Of those who had a biphasic reactions, the median time from the onset of symptoms to the initial administration of subcutaneous epinephrine was 190 minutes, versus 48 minutes for those without a biphasic reaction. Patients with or without biphasic reactions did not differ significantly in the incidence of initial epinephrine use, initial steroid use, or serious respiratory or cardiovascular symptoms on initial presentation. Two of 105 (2\%) [95\% CI:.2, 7] patients clinically benefitted from a 24-hour observation period. CONCLUSIONS: We found an overall incidence of biphasic reactions of 6\%, and an incidence of significant biphasic reactions of 3\%, among pediatric patients admitted with anaphylaxis. Delayed administration of subcutaneous epinephrine was associated with an increased incidence of biphasic reactions. Approximately 2\% of patients with anaphylaxis potentially benefitted from a 24-hour period of observation after symptoms had resolved.
This article was published in Pediatrics and referenced in Journal of Cancer Clinical Trials

Relevant Expert PPTs

Relevant Speaker PPTs

Recommended Conferences

Relevant Topics

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri, Food, Aqua and Veterinary Science Journals

Dr. Krish

agrifoodaquavet@omicsonline.com

1-702-714-7001 Extn: 9040

Clinical and Biochemistry Journals

Datta A

clinical_biochem@omicsonline.com

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

business@omicsonline.com

1-702-714-7001Extn: 9042

Chemical Engineering and Chemistry Journals

Gabriel Shaw

chemicaleng_chemistry@omicsonline.com

1-702-714-7001 Extn: 9040

Earth & Environmental Sciences

Katie Wilson

environmentalsci@omicsonline.com

1-702-714-7001Extn: 9042

Engineering Journals

James Franklin

engineering@omicsonline.com

1-702-714-7001Extn: 9042

General Science and Health care Journals

Andrea Jason

generalsci_healthcare@omicsonline.com

1-702-714-7001Extn: 9043

Genetics and Molecular Biology Journals

Anna Melissa

genetics_molbio@omicsonline.com

1-702-714-7001 Extn: 9006

Immunology & Microbiology Journals

David Gorantl

immuno_microbio@omicsonline.com

1-702-714-7001Extn: 9014

Informatics Journals

Stephanie Skinner

omics@omicsonline.com

1-702-714-7001Extn: 9039

Material Sciences Journals

Rachle Green

materialsci@omicsonline.com

1-702-714-7001Extn: 9039

Mathematics and Physics Journals

Jim Willison

mathematics_physics@omicsonline.com

1-702-714-7001 Extn: 9042

Medical Journals

Nimmi Anna

medical@omicsonline.com

1-702-714-7001 Extn: 9038

Neuroscience & Psychology Journals

Nathan T

neuro_psychology@omicsonline.com

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

John Behannon

pharma@omicsonline.com

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

social_politicalsci@omicsonline.com

1-702-714-7001 Extn: 9042

 
© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords