{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T22:54:51Z","timestamp":1784328891384,"version":"3.55.0"},"reference-count":65,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2019,8,4]],"date-time":"2019-08-04T00:00:00Z","timestamp":1564876800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Childhood allergy is common, and increasing. Many children are incorrectly labeled as having allergy or adverse drug reactions. This can pose a dilemma for anesthetists and lead to a change in practice or drug selection. We review the pathophysiology of hypersensitivity reactions and the implications for anesthesia of food allergy, atopy, and family history of allergy in children. The epidemiology of anaphylaxis is discussed. We discuss the common triggers of perioperative anaphylaxis in children and explore emerging triggers including chlorhexidine and sugammadex. Accurate data on pediatric perioperative anaphylaxis is limited worldwide, with marked geographic variation. This highlights the need for accurate local, district and\/or nationwide incident reporting. The clinical features, diagnosis, and management of anaphylaxis under anesthesia are discussed. We review the process of expert allergy testing following a suspected case of anaphylaxis to guide future safe anesthesia administration. The preoperative consultation is an opportunity for referral for allergy testing to allow de\u2010labeling. This has the potential for improved antibiotic stewardship and more effective treatment with first\u2010line therapeutic agents.<\/jats:p>","DOI":"10.1111\/pan.13703","type":"journal-article","created":{"date-parts":[[2019,8,5]],"date-time":"2019-08-05T01:14:47Z","timestamp":1564967687000},"page":"892-900","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["An update on allergy and anaphylaxis in pediatric anesthesia"],"prefix":"10.1111","volume":"29","author":[{"given":"Bojana","family":"Stepanovic","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Pain Medicine Perth Children's Hospital Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Sommerfield","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Pain Medicine Perth Children's Hospital Perth Western Australia Australia"},{"name":"Medical School The University of Western Australia Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michaela","family":"Lucas","sequence":"additional","affiliation":[{"name":"Medical School The University of Western Australia Perth Western Australia Australia"},{"name":"Department of Immunology Perth Children's Hospital Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8043-8541","authenticated-orcid":false,"given":"Britta S.","family":"von Ungern\u2010Sternberg","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Pain Medicine Perth Children's Hospital Perth Western Australia Australia"},{"name":"Medical School The University of Western Australia Perth Western Australia Australia"},{"name":"Telethon Kids Institute Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,8,4]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60309-8"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2008.10.049"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000003419"},{"key":"e_1_2_11_5_1","doi-asserted-by":"crossref","unstructured":"HarperN CookTM GarcezT LucasDN ThomasM KempH et al.Anaesthesia surgery and life\u2010threatening allergic reactions: report and findings of the Royal College of Anaesthetists' 6th National Audit Project: perioperative anaphylaxis (NAP6). Royal College of Anaesthetists; 2018 May 2018. Contract No.: 1.","DOI":"10.1016\/j.bja.2018.04.001"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.12350"},{"issue":"1","key":"e_1_2_11_7_1","first-page":"1","article-title":"2015 update of the evidence base: World Allergy Organization anaphylaxis guidelines","volume":"8","author":"Simons F","year":"2015","journal-title":"World Allergy Organ J"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)60220-7"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.18176\/jiaci.0046"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.13541"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2018.09.003"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkw008"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.13223"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0b013e3283466c13"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2005.tb06707.x"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11882-014-0501-1"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2222.2007.02682.x"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2007.08.023"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2007.09.040"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)60513-3"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2009.12.994"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3038.2008.00723.x"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3038.2012.01275.x"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aev401"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1213\/ane.0b013e3181602e0d"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0750-7658(05)81016-0"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aet117"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2008.05733.x"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(17)30116-9"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2011.03.003"},{"key":"e_1_2_11_31_1","unstructured":"McNicholL.Safety of Anaesthesia. A review of anaesthesia\u2010related mortality reporting in Australia and New Zealand 2012\u20132014. Australian and New Zealand College of Anaesthetists."},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2010.12.983"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iac.2009.04.004"},{"key":"e_1_2_11_34_1","unstructured":"Australia and New Zealand College of Anaesthetists.Perioperative Anaphylaxis Management Guidelines. Background Paper [Internet]. 2016 [cited 07\/05\/2019] from:http:\/\/www.anzca.edu.au\/documents\/bp-anaphylaxis-2016.pdf\/. Accessed May 07 2019."},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/aas.12855"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3038.2010.01006.x"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iac.2017.07.001"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2017.08.027"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2010.08.002"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X1204000515"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aes506"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.13081"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.12290"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms18061223"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00540-015-2105-x"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.12736"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00540-016-2280-4"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.4103\/0970-9185.155138"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5049.89898"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e31821b450f"},{"key":"e_1_2_11_51_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aev360"},{"key":"e_1_2_11_52_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1398-9995.2002.23797.x"},{"key":"e_1_2_11_53_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.14693"},{"key":"e_1_2_11_54_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.12360"},{"key":"e_1_2_11_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iac.2015.01.002"},{"key":"e_1_2_11_56_1","doi-asserted-by":"publisher","DOI":"10.1111\/pai.12915"},{"key":"e_1_2_11_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2014.03.014"},{"key":"e_1_2_11_58_1","doi-asserted-by":"publisher","DOI":"10.2500\/aap.2017.38.4064"},{"key":"e_1_2_11_59_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iac.2014.03.004"},{"key":"e_1_2_11_60_1","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.170.11.5667"},{"key":"e_1_2_11_61_1","doi-asserted-by":"publisher","DOI":"10.1159\/000328760"},{"key":"e_1_2_11_62_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2019.02.002"},{"key":"e_1_2_11_63_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjaceaccp\/mkt034"},{"key":"e_1_2_11_64_1","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X1704500504"},{"issue":"6","key":"e_1_2_11_65_1","first-page":"442","article-title":"Reducing the risk of anaphylaxis during anesthesia: 2011 updated guidelines for clinical practice","volume":"21","author":"Mertes PM","year":"2011","journal-title":"J Investig Allergol Clin Immunol"},{"key":"e_1_2_11_66_1","volume-title":"Classification and Descriptions of Allergic Reactions to Drugs. Drug allergy: Clinical Aspects, Diagnosis, Mechanisms, Structure\u2010Activity Relationships","author":"Baldo B","year":"2013"}],"container-title":["Pediatric Anesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pan.13703","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/pan.13703","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pan.13703","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T03:43:09Z","timestamp":1694058189000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pan.13703"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8,4]]},"references-count":65,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2019,9]]}},"alternative-id":["10.1111\/pan.13703"],"URL":"https:\/\/doi.org\/10.1111\/pan.13703","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.736349113.793567946","asserted-by":"object"}]},"ISSN":["1155-5645","1460-9592"],"issn-type":[{"value":"1155-5645","type":"print"},{"value":"1460-9592","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8,4]]},"assertion":[{"value":"2018-10-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-07-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-08-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}