Emergency Algorithm Ulm: Therapy of Drug induced Bradykinin mediated Angioedema
18 April 2018 (online)
Bradykinin mediated drug induced edema like ACE inhibitor induced angioedema is nearly exclusively located in the head and neck region. To date, there is no guideline and no officially approved therapy for this pathology available. Our aim is, to provide a structured therapeutic concept on the basis of a flow chart for acute therapy of drug induced bradykinin mediated angioedema.
We performed a literature research in PubMed for the analysis of the course of disease and available data about the above mentioned edema. Furthermore, we had the data of a doctoral thesis about the therapy and course of acute angioedema from our ENT university department Ulm. Other literature references were current guidelines (hereditary angioedema, anaphylaxis, airway management.
A flow chart emergency algorithm for acute therapy of bradykinin mediated drug induced angioedema was created. Focus was the decision criteria for intubation/airway management; pharmacological therapy: antihistamines and glucocorticoids versus antibradykinin treatment as well as recommendations for stationary monitoring.
Until now, therapy of drug induced bradykinin mediated angioedema is only 'off label' and without officially approved guidelines possible. Our emergency algorithm provides first approach for a structured therapeutic concept for this pathology.