Guidelines on the diagnosis and management of perioperative immediate hypersensitivity reactions 2025
Abstract
Objective: The Soci´et´e française d'anesth´ esie et de r´ eanimation (Sfar, the French society of anaesthesia and intensive care) and the Soci´et´e française d'allergologie (SFA, the French society of allergy) have collaborated to propose guidelines for the diagnosis and management of perioperative immediate hypersensitivity reactions. Design: A group of 23 French experts from the Sfar and the SFA was assembled. Any potential conflicts of interest were officially declared at the outset of the recommendations development process, which was conducted independently of any industry funding. The authors used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to assess the level of evidence in the literature. Methods: Four fields were defined: (1) Diagnostic assessment of perioperative immediate hypersensitivity reactions; (2) Risk factors for perioperative immediate hypersensitivity reactions; (3) Treatment in scheduled and emergency situations and; (4) Treatment of perioperative immediate hypersensitivity reactions. For each field, the aim of the recommendations was to answer questions formulated by the experts according to the Population, Intervention, Comparison, Outcome (PICO) model. Based on these questions, an extensive literature search covering the last 24 years was carried out using predefined keywords according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. The level of evidence was analysed using the GRADE method. The recommendations were formulated using the GRADE method, then voted on by all the experts using the GRADE grid method. Results: The experts' summary work and the application of the GRADE method resulted in 70 recommendations concerning 31 questions. After three rounds of voting and several amendments, strong agreement was reached on 70 recommendations. Of these recommendations, six had a high level of evidence (six GRADE 1), 16 had a low level of evidence (16 GRADE 2) and 48 were expert opinions. Finally, for one question, no recommendation could be made. Conclusion: There was strong agreement among the experts to formulate recommendations aimed at providing a benchmark for the diagnosis and management of perioperative immediate hypersensitivity reactions.
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BibTeX
@article{mertes2026guidelines,
title = {{Guidelines on the diagnosis and management of perioperative immediate hypersensitivity reactions 2025}},
author = {Paul Michel Mertès and Anca Chiriac and Charles Tacquard and Alain Facon and Sébastien Franchina and Aurélie Gouel-Chéron and Caroline Klingebiel and Corinne Lejus-Bourdeau and Diane Le Quang and Nidhal Leray-Touati and Dan Longrois and Claire Mailhol and Jean-Marc Malinosvsky and Isabelle Migueres and Moise Michel and Martine Morisset and Catherine Neukirch and Diane Pelletier de Chambure and Christelle Pellerin and Mélanie Perquin and Guillaume Pouessel and Cécile Rochefort-Morel and Elleni-Sofia Vaia and Joana Vitte and Anaïs Caillard and Pascal Demoly},
journal = {Journal of Allergy and Hypersensitivity Diseases},
year = {2026},
month = sep,
doi = {10.1016/j.jahd.2026.100068},
url = {https://univ-reims.hal.science/hal-05735251v1},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Guidelines on the diagnosis and management of perioperative immediate hypersensitivity reactions 2025
AU - Paul Michel Mertès
AU - Anca Chiriac
AU - Charles Tacquard
AU - Alain Facon
AU - Sébastien Franchina
AU - Aurélie Gouel-Chéron
AU - Caroline Klingebiel
AU - Corinne Lejus-Bourdeau
AU - Diane Le Quang
AU - Nidhal Leray-Touati
AU - Dan Longrois
AU - Claire Mailhol
AU - Jean-Marc Malinosvsky
AU - Isabelle Migueres
AU - Moise Michel
AU - Martine Morisset
AU - Catherine Neukirch
AU - Diane Pelletier de Chambure
AU - Christelle Pellerin
AU - Mélanie Perquin
AU - Guillaume Pouessel
AU - Cécile Rochefort-Morel
AU - Elleni-Sofia Vaia
AU - Joana Vitte
AU - Anaïs Caillard
AU - Pascal Demoly
PY - 2026
DA - 2026/09/02
JO - Journal of Allergy and Hypersensitivity Diseases
DO - 10.1016/j.jahd.2026.100068
UR - https://univ-reims.hal.science/hal-05735251v1
AB - Objective: The Soci´et´e française d'anesth´ esie et de r´ eanimation (Sfar, the French society of anaesthesia and intensive care) and the Soci´et´e française d'allergologie (SFA, the French society of allergy) have collaborated to propose guidelines for the diagnosis and management of perioperative immediate hypersensitivity reactions. Design: A group of 23 French experts from the Sfar and the SFA was assembled. Any potential conflicts of interest were officially declared at the outset of the recommendations development process, which was conducted independently of any industry funding. The authors used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to assess the level of evidence in the literature. Methods: Four fields were defined: (1) Diagnostic assessment of perioperative immediate hypersensitivity reactions; (2) Risk factors for perioperative immediate hypersensitivity reactions; (3) Treatment in scheduled and emergency situations and; (4) Treatment of perioperative immediate hypersensitivity reactions. For each field, the aim of the recommendations was to answer questions formulated by the experts according to the Population, Intervention, Comparison, Outcome (PICO) model. Based on these questions, an extensive literature search covering the last 24 years was carried out using predefined keywords according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. The level of evidence was analysed using the GRADE method. The recommendations were formulated using the GRADE method, then voted on by all the experts using the GRADE grid method. Results: The experts' summary work and the application of the GRADE method resulted in 70 recommendations concerning 31 questions. After three rounds of voting and several amendments, strong agreement was reached on 70 recommendations. Of these recommendations, six had a high level of evidence (six GRADE 1), 16 had a low level of evidence (16 GRADE 2) and 48 were expert opinions. Finally, for one question, no recommendation could be made. Conclusion: There was strong agreement among the experts to formulate recommendations aimed at providing a benchmark for the diagnosis and management of perioperative immediate hypersensitivity reactions.
SN - 2950-3124
SN - 2950-3124
ER -