ReviewClinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology2024
Management of Refractory Anaphylaxis: An Overview of Current Guidelines.
Review in Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed.
- Uncommon yet critical: Immediate hypersensitivity reactions to Gadobutrol in magnetic resonance imaging procedures.Asia Pacific allergy · 2026Article
- [How I treat anaphylaxis in children].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2026Article
- Refractory remimazolam-induced anaphylaxis and suspected Kounis syndrome requiring extracorporeal cardiopulmonary resuscitation: a case report.JA clinical reports · 2026Article
- Anaphylaxis: Clinical Criteria, Severity, and Clinical Courses.Immunology and allergy clinics of North America · 2026Review
- Biphasic, Refractory, and Persistent Anaphylaxis in Children.Clinical and translational allergy · 2026Article
- Kounis Syndrome in Cardiac Surgery: Pathophysiology, Antimicrobial Triggers, and Perioperative Recognition and Management.Medical sciences (Basel, Switzerland) · 2026Review
- Retrospective Evaluation of Patients Admitted to the Emergency Department Due to Anaphylaxis in Children: A Single-Center Study from Türkiye.Children (Basel, Switzerland) · 2026Article
- Severe anaphylactic shock suspectedly induced by injection of recombinant humanized type III collagen lyophilized fiber for facial skin improvement: a case report.Frontiers in allergy · 2026Article
- Acute Allergic Reactions and Severe Anaphylaxis: Underlying Causes, Management Strategies, and Future Directions.Archives of internal medicine research · 2026Article
- Optimizing Adrenaline Administration in Anaphylaxis: Clinical Practice Considerations and Safety Insights.Clinical and translational allergy · 2025Review
- Emergency Monitoring Following A Diagnosis of Anaphylaxis.Current allergy and asthma reports · 2025Review
- Exploring the anti-anaphylaxis potential of natural products: A Review.Inflammopharmacology · 2025Review
- Risk Factors for Refractory Anaphylaxis in the Emergency Department.Emergency medicine international · 2024Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
In this review, we compare different refractory anaphylaxis (RA) management guidelines focusing on cardiovascular involvement and best practice recommendations, discuss postulated pathogenic mechanisms underlining RA and highlight knowledge gaps and research priorities. There is a paucity of data supporting existing management guidelines. Therapeutic recommendations include the need for the timely administration of appropriate doses of aggressive fluid resuscitation and intravenous (IV) adrenaline in RA. The preferred second-line vasopressor (noradrenaline, vasopressin, metaraminol and dopamine) is unknown. Most guidelines recommend IV glucagon for patients on beta-blockers, despite a lack of evidence. The use of methylene blue or extracorporeal life support (ECLS) is also suggested as rescue therapy. Despite recent advances in understanding the pathogenesis of anaphylaxis, the factors that lead to a lack of response to the initial adrenaline and thus RA are unclear. Genetic factors, such as deficiency in platelet activating factor-acetyl hydrolase or hereditary alpha-tryptasaemia, mastocytosis may modulate reaction severity or response to treatment. Further research into the underlying pathophysiology of RA may help define potential new therapeutic approaches and reduce the morbidity and mortality of anaphylaxis.
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Registered trials
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