J. Lee , S. Ban , J. Han , S. Paik , J. Park , J. Jeong , Y. Kim , H. Kang
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引用次数: 0
Abstract
Introduction
Desensitization presents a promising strategy for reintroducing essential medications to patients experiencing hypersensitivity reactions. However, the process demands significant manual intervention from medical staff in order to adjust dosage and rate of each step. We aimed to assess the efficacy of a novel automated infusion pump (AIP) designed to streamline this process by automating drug administration.
Methods
We conducted a comparative evaluation of AIP versus manual infusion for rapid desensitization of anticancer agents at Seoul National University from November 2022 to February 2024. AIP is programmed to initiate and execute various specified protocols, progressing through predetermined steps automatically.
Results
Analysis of 754 desensitization procedures involving 182 patients revealed that 406 cases (53.8%) utilized the AIP; carboplatin (137 cases, 18.2%), oxaliplatin (127 cases, 16.8%), and rituximab (66 cases, 8.8%) were the most frequently administered medications. Breakthrough reaction (BTR) incidence did not significantly differ between manual and AIP methods for platinum-based agents such as carboplatin, oxaliplatin, and cisplatin (34.1% vs. 25%, p = 0.088) or taxanes such as paclitaxel and docetaxel (12.7% vs. 16.4%, p = 0.456). However, rituximab desensitization exhibited a significantly lower BTR rate with AIP (14.3%) compared to manual infusion (52.6%, p = 0.001), with similar up-dosing steps and infusion duration. Three instances of machine error necessitated a switch to manual infusion, but no adverse effects from infusion errors were reported.
Conclusions
The use of AIP for desensitization presents a safe and labor-saving alternative for manual desensitization, with particularly enhanced efficacy observed in rituximab desensitization compared to manual infusion.
期刊介绍：
Annals of Allergy, Asthma & Immunology is a scholarly medical journal published monthly by the American College of Allergy, Asthma & Immunology. The purpose of Annals is to serve as an objective evidence-based forum for the allergy/immunology specialist to keep up to date on current clinical science (both research and practice-based) in the fields of allergy, asthma, and immunology. The emphasis of the journal will be to provide clinical and research information that is readily applicable to both the clinician and the researcher. Each issue of the Annals shall also provide opportunities to participate in accredited continuing medical education activities to enhance overall clinical proficiency.
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