SummaryThe prevalence of latex allergy has increased since the 1980s. As latex is found throughout hospitals and operating theatres, careful planning is required for latex-allergic patients who present pre-operatively. We conducted a postal survey of 269 departments of anaesthesia in England and Wales; responses were received from 208 (77%). Of these, 198 (95%) had a latex allergy protocol and 181 (87%) had a store of latex-free equipment. Only 113 (54%) had a named nurse and 58 (28%) had a named consultant responsible for the update of latex allergy provisions. Access to allergy clinics and further investigations were available to 189 (91%). Many respondents called for national guidelines. We are reassured that the majority of trusts have an up-to-date latex allergy protocol and latex-free equipment store. However, relatively few have nominated members of staff responsible for these and peri-operative care of susceptible patients.

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Immune therapy to ease the burden of sepsis has thus far failed to consistently improve patient outcomes. Advances in cancer immune therapy and awareness that prolonged immune-suppression in sepsis can leave patients vulnerable to secondary infection and death have driven resurgence in the field of sepsis immune-therapy investigation. As we develop and evaluate these novel therapies, we must learn from past experiences where single-mediator targeted immune therapies were blindly delivered to heterogeneous patient cohorts with complex and evolving immune responses. Advances in genomics, proteomics, metabolomics, and point-of-care technology, coupled with a better understanding of sepsis pathogenesis, have meant that personalised immune-therapy is on the horizon. Here, we review the complex immune pathogenesis in sepsis and the contemporary immune therapies that are being investigated to manipulate this response. An outline of the immune biomarkers that may be used to support this approach is also provided.

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