Anafilaktički šok

master's thesis

• Title (english): Anaphylactic shock
• Author: Martina Cobenzl
• Mentor: Dinko Tonković (mentor)
• Committee member: Dinko Tonković (predsjednik povjerenstva)
• Committee member: Slobodan Mihaljević (član povjerenstva)
• Committee member: Daniela Bandić Pavlović (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Anaesthesiology, Resuscitation and Intensive Care in Surgical Specialities); Zagreb
• Defense date and country: 2023-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Anesthesiology and Reanimatology

Abstract

Anafilaktički šok je životno ugrožavajuće stanje do kojeg dolazi zbog masivne vazodilatacije izazvane medijatorima koji se otpuštaju iz mastocita. Snizi se periferni otpor te se izgubi arteriovenska razlika tlakova. Najčešće se radi o IgE posredovanoj reakciji, ali postoje i drugi imunološki te neimunološki mehanizmi koji mogu dovesti do anafilaksije. Alergeni koji izazivaju anafilaktičku reakciju najčešće su hrana, lijekovi te otrovi insekata. Znakovi i simptomi anafilaksije obično se jave unutar jednog do dva sata od izloženosti alergenu. U do dvije trećine slučajeva radi se o idiopatskoj anafilaksiji. Dijagnoza se postavlja pomoću smjernica koje se temelje na kliničkim kriterijima. Teži stupnjevi alergijske reakcije smatraju se anafilaksijom. Pri akutnom zbrinjavanju pacijenta sa anafilaksijom te anafilaktičkim šokom potrebno je zbrinuti dišni put, primijeniti intravenski fiziološku otopinu te primijeniti adrenalin. Adrenalin je prva linija terapije anafilaksije te se najčešće daje intramuskularno u bedreni mišić u dozi 0,3-0,5 mL te u koncentraciji 1:1000. Preporuča se korištenje autoinjektora adrenalina, a pacijenti koji u anamnezi imaju anafilaksiju moraju sa sobom uvijek nositi autoinjektor adrenalina te biti educirani za njegovu uporabu. Nakon akutne anafilaktičke reakcije pacijente je potrebno opservirati jer može doći do bifazične reakcije. Pacijentima se preporučuje izbjegavanje alergena. Imunoterapija specifičnim alergenima je aktivno liječenje alergija čiji je cilj postići toleranciju na alergen.

Abstract (english)

Anaphylactic shock is a life-threatening condition that occurs due to systemic vasodilation caused by mediators released from mast cells. Peripheral resistance is lowered and the arteriovenous pressure difference is lost. Generally, it is an IgE-mediated reaction, but there are other immunological and non-immunological mechanisms that can lead to anaphylaxis. Allergens that cause an anaphylactic reaction are most often food, drugs and insect venoms. Signs and symptoms of anaphylaxis usually appear within one to two hours after exposure to the allergen. In up to two thirds of cases the cause is unknown and anaphylaxis is idiopathic. Diagnosis is made using guidelines based on clinical criteria. Severe grade of allergic reaction is considered anaphylaxis. In the acute treatment of a patient with anaphylaxis and anaphylactic shock, it is necessary to manage the airway, administer intravenous saline solution and administer adrenaline. Adrenaline is the first line of therapy for anaphylaxis and it is given by intramuscular injection in the thigh muscle. It is administered in a dose of 0.3-0.5 mL and in a concentration of 1:1000. The use of an adrenaline auto-injector is recommended, and patients with a history of anaphylaxis must always carry an adrenaline auto-injector with them and know how to apply it. After an acute anaphylactic reaction, patients should be observed, as a biphasic reaction may occur. Patients are advised to avoid allergens. Allergen-specific immunotherapy is a treatment for allergies. The goal of immunotherapy is allergen tolerance.

• Keywords: anafilaksija; šok; adrenalin
• Keywords (english): anaphylaxis; shock; adrenaline
• Language: croatian
• URN:NBN: urn:nbn:hr:105:204707
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-10-23 12:30:12