Hypersensitivity, Immediate Clinical Trial
— CADECAPOfficial title:
Clinical Determinants in Perioperative Allergic Immediate Hypersensitivity
NCT number | NCT03918772 |
Other study ID # | 2018-043 |
Secondary ID | |
Status | Completed |
Phase | |
First received | |
Last updated | |
Start date | November 5, 2018 |
Est. completion date | March 22, 2019 |
Verified date | March 2019 |
Source | Assistance Publique - Hôpitaux de Paris |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Observational |
The clinical presentation of perioperative allergic and non-allergic clinical reactions is
often considered undistinguishable while the accurate analysis of clinical cases shows
striking clinical differences which might be predictive of the etiological diagnosis
(allergic versus non-allergic).
The four-step Ring and Messmer clinical scale helps to guide acute management of immediate
hypersensitivity accordingly to the clinical presentation although this scale does not take
into account the mechanism involved (i.e. allergic versus non-allergic). Non-allergic
clinical reactions are usually non-life-threatening and may, sometimes, spontaneously resolve
in contrast to allergic reactions which are mainly severe and life-threatening conditions,
typically called anaphylaxis.
The cornerstones of anaphylaxis management are fluid therapy and epinephrine. However, poor
outcome has been reported as a result of delayed treatment and/or inappropriate management of
perioperative anaphylaxis.
Status | Completed |
Enrollment | 153 |
Est. completion date | March 22, 2019 |
Est. primary completion date | November 5, 2018 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility |
Inclusion criteria: - Patients having experienced a perioperative immediate hypersensitivity (including the obstetrical setting) according to one grade of the Ring and Messmer clinical scale, for whom: - The clinical history is known and has been related to perioperative immediate hypersensitivity; - The biological assessment including plasma histamine and/or tryptase (and serum IgE when available) was performed after the onset of immediate hypersensitivity according to current guidelines; - The allergological assessment including skin tests performed by the collaborators of this study was carried out according to current guidelines in surviving patients Exclusion criteria: • Patients who decline to be involved in the study |
Country | Name | City | State |
---|---|---|---|
France | Assistance Publique-Hôpitaux de Paris | Paris |
Lead Sponsor | Collaborator |
---|---|
Assistance Publique - Hôpitaux de Paris |
France,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Identification of the predictive muco-cutaneous signs of perioperative allergic immediate hypersensitivity as assessed by the Ring and Messmer clinical scale | muco-cutaneous signs (generalized erythema and/or extensive urticaria and/or angioedema) | From date of the perioperative clinical reaction up to 6 hours | |
Primary | Identification of the predictive heart rate of perioperative allergic immediate hypersensitivity as assessed by the Ring and Messmer clinical scale | heart rate (beat/min.) | From date of the perioperative clinical reaction up to 6 hours | |
Primary | Identification of the predictive arterial pressure of perioperative allergic immediate hypersensitivity as assessed by the Ring and Messmer clinical scale | arterial pressure (mmHg) | From date of the perioperative clinical reaction up to 6 hours | |
Primary | Identification of the predictive upper gastrointestinal symptoms of perioperative allergic immediate hypersensitivity as assessed by the Ring and Messmer clinical scale | digestive signs (vomiting) | From date of the perioperative clinical reaction up to 6 hours | |
Primary | Identification of the predictive lower gastrointestinal symptoms of perioperative allergic immediate hypersensitivity as assessed by the Ring and Messmer clinical scale | digestive signs (diarrhea) | From date of the perioperative clinical reaction up to 6 hours | |
Primary | Identification of recurrence of perioperative allergic immediate hypersensitivity as assessed by the Ring and Messmer clinical scale | recurrence of symptoms following a symptom-free response | From date of the perioperative clinical reaction up to 6 hours | |
Secondary | Drugs involved in adverse reactions as assessed by the Ring and Messmer clinical scale | To identify the drugs involved in the onset of perioperative allergic clinical reactions and compare our results to those provided in the different international epidemiologic studies regarding perioperative immediate hypersensitivity. | From date of the perioperative clinical reaction and up to 100 months | |
Secondary | Negative predictive values of skin tests in allergic and non-allergic patients | Negative skin-tested agents administered according to the results of allergological follow-up during subsequent anesthetics in allergic and non-allergic patients | Up to 5 years after the allergologic follow-up | |
Secondary | Participants with treatment-related adverse events as assessed by by CTCAE v4.0 and fluid therapy | To identify the number of patients who received fluid therapy (volume, type) in allergic hypersensitivity | Through study completion, an average of 2 years | |
Secondary | participants with treatment-related adverse events as assessed by CTCAE v4.0 and vasoconstrictive agents | To identify the number of patients who received vasoconstrictive agents (ephedrine, neosynephrine, epinephrine, norepinephrine) and corresponding cumulative doses | Through study completion, an average of 2 years | |
Secondary | participants with treatment-related adverse events as assessed by CTCAE v4.0 and salbutamol and/or steroids | To identify the number of patients who received salbutamol, steroids and corresponding doses | Through study completion, an average of 2 years | |
Secondary | Participants with treatment-related adverse events as assessed by CTCAE v4.0 and intensive care unit admission | To identify the number of patients who were admitted in intensive care unit | Through study completion, an average of 2 years | |
Secondary | Participants with treatment-related adverse events as assessed by CTCAE v4.0 and morbidity | To report the morbidity cases including cardiac and/or renal and/or hepatic and/or neurologic failure(s) after perioperative allergic immediate hypersensitivity | Through study completion, an average of 2 years | |
Secondary | Participants with treatment-related adverse events as assessed by CTCAE v4.0 and mortality | To report the mortality cases after perioperative allergic immediate hypersensitivity | Through study completion, an average of 2 years |
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