TY - JOUR
T1 - Angioedema
T2 - Classification, management and emerging therapies for the perioperative physician
AU - Misra, Lopa
AU - Khurmi, Narjeet
AU - Trentman, Terrence L.
N1 - Publisher Copyright:
© 2016 Indian Journal of Anaesthesia.
PY - 2016/8
Y1 - 2016/8
N2 - Angioedema is a rare condition which manifests as sudden localised, non‑pitting swelling of certain body parts including skin and mucous membranes. It is vital that anaesthesiologists understand this condition, as it may present suddenly in the perioperative period with airway compromise. To identify literature for this review, the authors searched the PubMed, Medline, Embase, Scopus and Web of Science databases for English language articles covering a 10‑year period, 2006 through 2016. Angioedema can be either mast‑cell mediated or bradykinin‑induced. Older therapies for histaminergic symptoms are well known to anaesthesiologists (e.g., adrenaline, anti‑histamines and steroids), whereas older therapies for bradykinin‑induced symptoms include plasma and attenuated androgens. New classes of drugs for bradykinin‑induced symptoms are now available, including anti‑bradykinin, plasma kallikrein inhibitor and C1 esterase inhibitors. These can be used prophylactically or as rescue medications. Anaesthesiologists are in a unique position to coordinate perioperative care for this complex group of patients.
AB - Angioedema is a rare condition which manifests as sudden localised, non‑pitting swelling of certain body parts including skin and mucous membranes. It is vital that anaesthesiologists understand this condition, as it may present suddenly in the perioperative period with airway compromise. To identify literature for this review, the authors searched the PubMed, Medline, Embase, Scopus and Web of Science databases for English language articles covering a 10‑year period, 2006 through 2016. Angioedema can be either mast‑cell mediated or bradykinin‑induced. Older therapies for histaminergic symptoms are well known to anaesthesiologists (e.g., adrenaline, anti‑histamines and steroids), whereas older therapies for bradykinin‑induced symptoms include plasma and attenuated androgens. New classes of drugs for bradykinin‑induced symptoms are now available, including anti‑bradykinin, plasma kallikrein inhibitor and C1 esterase inhibitors. These can be used prophylactically or as rescue medications. Anaesthesiologists are in a unique position to coordinate perioperative care for this complex group of patients.
KW - Airway
KW - Angioedema
KW - Bradykinin
KW - C1 esterase inhibitor
KW - Histamine
UR - http://www.scopus.com/inward/record.url?scp=84982973190&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84982973190&partnerID=8YFLogxK
U2 - 10.4103/0019-5049.187776
DO - 10.4103/0019-5049.187776
M3 - Review article
AN - SCOPUS:84982973190
SN - 0019-5049
VL - 60
SP - 534
EP - 541
JO - Indian Journal of Anaesthesia
JF - Indian Journal of Anaesthesia
IS - 8
ER -