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Reports outline angioneurotic edema study results from State University of New York
2009 AUG 3 - (NewsRx.com) -- According to recent research from the United States, "Hereditary angioedema (HAE), deficiency of C1 esterase inhibitor, poses a risk of airway compromise during trauma, including surgery, due to activation of the complement cascade. Classical surgical management includes emergent/slash tracheostomy and cricothyrotomy, associated with high complication rates." "We provide here an evidence-based review of available medical literature to construct guidelines for managing patients with HAE pre- and intro-operatively. We also describe our experience with a patient for whom we cared using these guidelines. Our objective was to explain new preventive measures to prevent airway compromise in HAE and their level of evidence for averting potential therapeutic misadventure. We analyzed PUBMED literature regarding airway management and etiology of angioedema and its prevention, followed by application of guidelines based on these data in a patient with HAE undergoing inguinal hernia repair. An analysis of contemporary literature yielded key points: (1) using a Cook Exchange catheter to facilitate re-intubation, (2) measuring cuff leak pressure to verify whether airway pressure had increased during surgery, (3) visualizing the airway directly using a fiberoptic laryngoscope connected to a digital fat-screen monitor for real-time assessment, (4) following conventional dictum to double stanozolol dosages 2 weeks before admission, (5) administering fresh frozen plasma pre- and intraoperatively, and (6) preparing recombinant C1 esterase inhibitor for instantaneous intraoperative use; and using FDA-approved human-derived C1-esterase inhibitor prophylactically," wrote A.M. Szema and colleagues, State University of New York. The researchers concluded: "Biotechnology in the form of novel bill currently available and in-practice medical devices, as well as new therapeutic agents, have expanded the armamentarium for safely managing patients with HAE pre- and intraoperatively." Szema and colleagues published their study in Allergy and Asthma Proceedings (Modern preoperative and intraoperative management of hereditary angioedema. Allergy and Asthma Proceedings, 2009;30(3):338-342). For additional information, contact A.M. Szema, SUNY Stony Brook, Dept. of Medical, School Medical, T16-041, Stony Brook, NY 11794, USA. Publisher contact information for the journal Allergy and Asthma Proceedings is: Ocean Side Publications Inc., 95 Pitman St., Providence, RI 02906, USA. Keywords: United States, Stony Brook, Allergies, Allergy Medicine, Angioneurotic Edema, Asthma, C1 Esterase Inhibitor, Congenital Lobar Emphysema, Cricothyrotomy, Drugs, Enzyme Research, Pulmonology, Surgery, Therapy, Tracheostomy, Treatment, State University of New York. This article was prepared by Biotech Business Week editors from staff and other reports. Copyright 2009, Biotech Business Week via NewsRx.com.
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