在患有鱼类过敏的患者中评估外科手术期间的蛋白质胺反应:一项回顾性观察性研究
Mohanad R Youssef1, Eryberto Martinez1, Terrique M Pinnock2
1Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, AZ.
Journal of cardiothoracic and vascular anesthesia
|September 11, 2024
概括
鱼类过敏史并没有增加外科手术期间的蛋白胺反应风险. 这项研究发现,对鱼类过敏患者的过敏反应和蛋白质胺反应很少发生,这表明交叉反应不太可能.
科学领域:
- 麻醉学 麻醉学
- 过敏和免疫学 过敏和免疫学
- 心血管外科心血管外科
背景情况:
- 质氨酸用于逆转心脏手术期间的氨酸抗凝作用.
- 患有鱼类过敏的患者有时会因为潜在的交叉反应性而被警告不要服用蛋白胺.
- 鱼类过敏患者中蛋白胺反应的实际发病率尚未得到充分确立.
研究的目的:
- 为了评估成年患者中经过手术前期的前胺反应的发生率和严重程度,有记录的鱼类过敏史.
- 为了确定鱼类过敏是否是原氨酸诱导的过敏反应的重要危险因素.
主要方法:
- 在一个大型学术高等推中心进行的回顾性观察研究.
- 包括患有鱼类过敏的成年患者,在2008年至2018年期间接受了需要蛋白质胺的手术.
- 经过手术期间的事件和手术后对过敏反应或前胺激素反应的评估.
主要成果:
- 在214名对鱼类过敏的患者中,只有2人 (<1%) 经历过敏反应或原胺反应.
- 心脏手术是最常见的手术 (67%).
- 虽然重症监护室的入院和长时间住院是常见的,但30天死亡率很低 (1%).
结论:
- 鱼类过敏和蛋白质胺之间的交叉反应似乎不太可能.
- 在接受手术的鱼类过敏患者中,过敏反应和前胺反应很少发生.
- 避免仅仅基于鱼类过敏史的蛋白质胺,不建议在必要时逆转肝素.
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