Patients on subcutaneous allergen immunotherapy are at risk of intramuscular injections

Allergy, Asthma & Clinical Immunology

Laura Kim¹  Immaculate Nevis³  Ryan Potts²  Clark Eeuwes³  Arunmozhi Dominic³  Harold L Kim³ 

[1] Department of Anatomy and Cell Biology, McGill University, Montreal, QC, Canada

[2] Department of Biology, University of Waterloo, Waterloo, ON, Canada

[3] Schulich School of Medicine & Dentistry, Western University, London, ON, Canada

关键词: Injections;    Allergy syringe;    Needle length;    Skin-to-muscle depth;    Ultrasound;    Subcutaneous immunotherapy;    Allergen-specific immunotherapy;   

Others  :  791807
DOI  :  10.1186/1710-1492-10-22

 received in 2014-03-07, accepted in 2014-04-21,  发布年份 2014

【 摘 要 】

Background

Allergen-specific subcutaneous immunotherapy is an effective treatment for certain allergic disorders. Ideally, it should be administered into the subcutaneous space in the mid-posterolateral upper arm. Injections are commonly given using a standard allergy syringe with a needle length of 13 mm. Therefore, there is a risk of intramuscular administration if patients have a skin-to-muscle depth <13 mm, which may increase the risk of anaphylaxis. The objective of this study was to determine whether the needle length of a standard allergy syringe is appropriate for patients receiving subcutaneous immunotherapy.

Methods

Ultrasounds of the left posterolateral arm were performed to measure skin-to-muscle depth in 200 adults receiving subcutaneous immunotherapy. The proportion of patients with a skin-to-muscle depth >13 mm vs. ≤13 mm was assessed and baseline characteristics of the two groups were compared. The proportion of patients with skin-to-muscle depths > 4 mm, 6 mm, 8 mm and 10 mm were also calculated. Multivariable logistic regression was performed to identify predictors of skin-to-muscle depth.

Results

Of the 200 patients included in the study, 80% had a skin-to-muscle depth ≤13 mm; the majority (91%) had a skin-to-muscle depth >4 mm. Body mass index was found to be a significant predictor of skin-to-muscle-depth.

Conclusions

Most patients receiving subcutaneous immunotherapy have a skin-to-muscle depth less than the needle length of a standard allergy syringe (13 mm). These patients are at risk of receiving injections intramuscularly, which may increase the risk of anaphylaxis. Using a syringe with a needle length of 4 mm given at a 45° angle to the skin may decrease this risk.

【 授权许可】

   
2014 Kim et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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