Perioperative latex hypersensitivity reactions: an integrative literature review

Abstract

This article characterizes hypersensitivity reactions during anesthetic-surgical procedures.This integrative literature review was conducted in the LILACS, CINAHL, COCHRANE and MEDLINE databases including papers published from 1966 to September 2011. A total of 17 case reports, two prevalence studies and one cohort study were identified. Latex reactions were mainly type III and the primary source of intraoperative reaction was latex gloves. The average time for clinical manifestation was 59.8 minutes after anesthetic induction; 44.4% of patients reported a reaction to latex at the pre-anesthetic evaluation. It was determined that the history of allergic reactions to latex obtained in the pre-anesthetic evaluation does not ensure the safety of patients if the staff is inattentive to the severity of the issue. There is also a tendency to initially attribute the anaphylactic event to the anesthetic drugs.Descriptors: Nursing; Latex Hypersensitivity; Perioperative Care; Review. Hipersensibilidad al latex en el peri-operatório: una revisión integradora de la literaturaEste estudio tuvo como objetivo caracterizar las reacciones de hipersensibilidad al látex en la anestesia. Ha sido realizada una revisión integradora de la literatura en LILACS, CINAHL, COCHRANE y MEDLINE, con una selección de artículos publicados en periódicos indexados de 1966 hasta septiembre 2011. Fueron identificados 17 casos clínicos, 2 estudios de prevalencia y 1 de la cohorte. Las reacciones al látex fueron en su mayoría del tipo III y la principal fuente de reacción intra-operatoria fue el contacto con los guantes de látex. El tiempo medio hasta la aparición de respuesta fue de 59.8 minutos después de la inducción, 44,4% de los pacientes informaron una reacción al látex en el periodo pre-anestésico. La historia de reacciones alérgicas al látex en el periodo preanestésico no garantiza la seguridad de los pacientes si el profesional no está atento a la gravedad del problema. Al principio, se tiende a atribuir que el efecto de la anafilaxia se debe a los medicamentos anestésicos.

Latex allergy and its clinical features among healthcare workers at Mankweng Hospital, Limpopo Province, South Africa

“…[1] The use of NRL gloves has increased because of the emergence of the human immunodeficiency virus (HIV) in the late 1980s. [1] These NRL gloves were produced with an excess of residual proteins and powder.…”

“…[1] The use of NRL gloves has increased because of the emergence of the human immunodeficiency virus (HIV) in the late 1980s. [1] These NRL gloves were produced with an excess of residual proteins and powder. [1] Healthcare workers (HCWs) are susceptible to sensitisation and subsequent development of latex allergy because of frequent exposure to NRL gloves and powder.…”

“…[1] These NRL gloves were produced with an excess of residual proteins and powder. [1] Healthcare workers (HCWs) are susceptible to sensitisation and subsequent development of latex allergy because of frequent exposure to NRL gloves and powder. [2] In addition, the prevalence in certain groups, such as people who underwent multiple operations involving exposure to NRL-containing materials at an early age, and those with spina bifida, urological abnormalities and short-bowel syndrome, has been reported to be up to 60% in earlier studies.…”

“…[4] Notably, about 50% of medical devices contain latex, so care has to be taken to identify them and avoid contact by latex-sensitised and allergic individuals. [1] In highly industrialised countries such as those of Europe and North America, the latex epidemic in HCWs has been partly halted by prevention strategies such as lowering the protein content in gloves [5] recommended by task forces of the European and American allergy associations. [5] New cases of NRL allergy have been significantly reduced, and in certain circumstances have disappeared, in countries and hospitals where health authorities have enforced the use of lowallergen/low-protein and non-powdered protective gloves.…”

Molecular profile of sensitization in subjects with short occupational exposure to latex

“…However, chemical treatment (hydrolysis) and the addition of substances such as ammonium hydroxide, thiurams or carbamates cause that users are exposed to a complex mixture of residual chemicals and the hydrolyzed latex peptides that seem to be involved in type 1 allergic reactions [36,37]. Gloves made from NRL have been in use since the 19th century as a means of protecting patients and healthcare workers from contracting infectious diseases; the use of latex gloves has increased more than tenfold over the last 30 years [38]. However, the international scientific community has paid attention to allergic-type reactions to NRL only since the beginning of the 1980s, despite the fact that reference to this problem started appearing over 65 years ago [39][40][41].…”