19. Management of Refractory Anaphylaxis: An Overview of Current Guidelines

Management of Refractory Anaphylaxis: An Overview of Current Guidelines

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CEUs: 2 Clinical

Average read time: 30 to 40 minutes

Short Summary of the Article:

The article, titled “Management of Refractory Anaphylaxis: An Overview of Current Guidelines,” reviews existing guidelines on the treatment of refractory anaphylaxis (RA), particularly focusing on the cardiovascular aspects. RA occurs when patients do not respond adequately to initial doses of intramuscular (IM) adrenaline. The article discusses various treatment options, including the administration of additional doses of adrenaline, fluid resuscitation, and the use of second-line treatments such as vasopressors (e.g., noradrenaline), glucagon, and methylene blue. The paper also highlights the knowledge gaps in managing RA and calls for more research to clarify the pathophysiology behind RA.

Learning Outcomes 

Upon completion of this activity, you should have an understanding of:

1. The definition and recognition of refractory anaphylaxis (RA): Practitioners will learn how to identify RA, which occurs when two or more doses of adrenaline fail to resolve anaphylaxis.
2. Appropriate use of adrenaline and second-line treatments: The importance of timely adrenaline administration and the role of vasopressors like noradrenaline in cases of persistent cardiovascular collapse.
3. Management strategies for severe cases of RA: How to employ fluid resuscitation, glucagon for beta-blocker patients, and when to consider advanced therapies like extracorporeal life support (ECLS).

(Max of 3 Attempts)