Abstract
Anaphylaxis is an acute allergic reaction with rapid clinical development and risk of death. This article provides an analysis of literary sources devoted to intensive care of anaphylaxis in childhood. It was revealed that the prevalence of anaphylaxis is increasing, in children and adolescents as well. The main triggers of anaphylaxis in pediatric practice include food products, insect bites and drugs. Anaphylaxis is an IgE-mediated hypersensitivity reaction of type 1, characterized by the release of chemical mediators that lead to smooth muscle contraction, increased permeability and vasodilation and vagal activation. Clinically, anaphylaxis is manifested by allergic skin rash, angioedema, obstruction of the upper respiratory tract (URT), broncho-obstructive syndrome (BOS), arterial hypotension, tachycardia. Intensive care for anaphylaxis in children begins with stabilization of the condition: stopping the entry of a possible allergen into the body, hospitalization in the anesthesiology and intensive care unit, restoring patency of the URT, conducting oxygen therapy, monitoring vital functions. The first-line drug for the treatment of anaphylaxis in children is adrenaline at a dose of 0.01 mg/kg, which stops all the main pathophysiological links of anaphylaxis. Adrenaline autoinjectors are not used in the Russian Federation. Second-line drugs for intensive care for anaphylaxis in children include glucocorticosteroids (GCS), antihistamines, bronchodilators and infusion therapy. The effectiveness of GCS in anaphylaxis in children has not been proven, antihistamines can relieve skin manifestations of an allergic reaction, but do not affect vital disorders. Bronchodilators reduce BOS and are an additional treatment, while infusion therapy eliminates hypovolemia. Knowledge and timely implementation of modern care algorithms for anaphylaxis in children and adolescents will improve the quality of emergency care and reduce the risk of fatal outcomes in this pathology.
Published Version
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