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Evidence summaries

Adrenaline (Epinephrine) for the Treatment of Anaphylaxis with and Without Shock

Adrenaline is effective for anaphylaxis although there is no evidence from randomized controlled trials. Level of evidence: "A"

The quality of evidence is upgraded by very large magnitude of effect.

Use adrenaline as first line treatment for anaphylaxis.

Summary

There are no randomized controlled trials (Cochrane review [Abstract] 1) comparing adrenaline with no intervention, placebo or other adrenergic agonists in the treatment of anaphylaxis. Several observational studies and case series show a rapid and often dramatic effect of adrenaline, and a better prognosis for patients who receive adrenaline early compared to those who receive no or delayed adrenaline.

    References

    • Sheikh A, Shehata YA, Brown SG, Simons FE. Adrenaline (epinephrine) for the treatment of anaphylaxis with and without shock. Cochrane Database Syst Rev 2008;(4):CD006312 [Review content assessed as up-to-date: 29 November 2010]. [PubMed]

Primary/Secondary Keywords