アナフィラキシー発症時にヒスタミンを測定するための取り組み

Efforts to Measure Histamine at the Onset of Anaphylaxis

要旨

　アナフィラキシー発症時には，ヒスタミンとトリプターゼを測定することが推奨されている。ヒスタミンの測定は発症後5-10分以内の採血と20分以内の遠心分離が必要であるが，臨床的に困難である。当施設手術室では，ヒスタミンを適切に測定するため，手順書の作成，検査セットおよび治療薬セットの作成，2つのセットを同時に搬入する仕組み化，検査室との連携を行った。この取り組みにより，時間内の採血と遠心分離を達成できた。

　At the onset of anaphylaxis, the initial treatment is the top priority, but the measurement of histamine and tryptase at both the onset and after 24 hours post-onset will help confirm the diagnosis. Histamine is rapidly hydrolyzed, and its half-life in plasma is only a few minutes. Blood samples for histamine measurements should therefore be collected 5-10 minutes after the onset of anaphylaxis. The blood should also be centrifuged within 20 minutes after its collection. However, since anaphylaxis occurs unexpectedly, early blood sampling is often challenging in clinical practice. To help clinicians measure histamine at the onset of anaphylaxis, we created a procedure manual and set up the necessary supplies and therapeutic agents by collaborating with our hospital’s laboratory. We also established a system in which the therapeutic agents and supplies are delivered simultaneously at the onset of anaphylaxis. With this system we are now able to consistently achieve timely blood collection and centrifugation in cases involving anaphylaxis.