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Comparison of international guidelines for the emergency medical management of anaphylaxis.

机译：过敏性反应紧急医疗管理国际准则的比较。

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BACKGROUND: Guideline-based treatment approaches for managing anaphylaxis are widely believed to result in good outcomes, but the strength of evidence underpinning the recommendations made therein is unclear. OBJECTIVE: To identify and compare national guidelines for the emergency medical management of anaphylaxis and to describe the extent to which the evidence base in support of key recommendations is made clear. METHODS: We systematically searched key medical databases and contacted the World Allergy Organization and anaphylaxis charities in several countries to identify national guidelines. Full text copies of relevant papers were obtained and, where necessary, translated. Data were abstracted onto a customized data extraction sheet; this process was independently checked by a second reviewer. RESULTS: Guidelines originating from Australia, Canada, Russia, UK, Ukraine and the USA were identified. While these were in agreement on the broad principles of management, there were important variations inrelation to the treatments to be used and the dose and route of administration of these preparations. Most guidelines failed to make clear the strength of evidence underpinning the recommendations being made. CONCLUSIONS: There are important international differences in the recommended emergency management of anaphylaxis. It is important that an agreed core evidence-based guideline for the management of anaphylaxis is now developed, which can then be adapted for national/local use. Clinicians need to be aware of the limitations of existing guidelines.
机译：背景：人们普遍认为基于指南的过敏反应治疗方法可产生良好的疗效，但尚不清楚是否有足够证据支持其中的建议。目的：确定和比较过敏性疾病紧急医疗管理的国家指南，并描述支持关键建议的证据基础的明确程度。方法：我们系统地搜索了重要的医学数据库，并与世界过敏组织和一些国家的过敏反应慈善机构联系，以确定国家指南。获得了相关论文的全文，并在必要时进行了翻译。数据被提取到定制的数据提取表上;此过程由第二位审阅者独立检查。结果：确定了源自澳大利亚，加拿大，俄罗斯，英国，乌克兰和美国的指南。尽管这些在广泛的管理原则上是一致的，但与所用治疗方法以及这些制剂的剂量和给药途径有关的重要变化。大多数准则未能明确表明所提出建议的依据。结论：建议的过敏反应应急管理存在重要的国际差异。重要的是，现在应制定商定的基于核心证据的过敏反应管理指南，然后可以将其修改为适合国家/地方使用。临床医生需要意识到现有指南的局限性。

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