Intraoperative anaphylaxis to latex

Swartz, J.; Braude, B. M.; Gilmour, Robert F.; Shandling, Barry; Gold, Milton

doi:10.1007/bf03006333

Cited by 57 publications

(8 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Hypersensitive reactions to natural rubber products are increasingly seen, the commonest being type IV Belsito 1990;Swartz et al 1990;Sussman, Tarlo & Dolovich 1991). These hypersensitivity reactions to latex include contact eczema, contact urticaria, rhinitis, conjunctivitis, flushing, angioedema, cardiovascular and respiratory symptoms such as wheezing, and anaphylactic shock.…”

Section: Discussionmentioning

confidence: 99%

Hypersensitivity to natural rubber: a potentially life‐threatening complication under anaesthesia

Bach

1992

Pediatric Anesthesia

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Hypersensitivity to natural rubber: a potentially life‐threatening complication under anaesthesia

Bach

1992

Pediatric Anesthesia

View full text Add to dashboard Cite

show abstract

“…Since the first report on IgE-mediated symptoms in an adult in 1927 [3], several other cases have been reported on children with anaphylactic reactions to latex [70, 71, 72, 73, 74, 75, 76, 77, 78, 79]. Most of these children were spina bifida patients or belonged to other high-risk groups, operated several times.…”

Section: Clinical Featuresmentioning

confidence: 99%

Latex Allergy in Children

Niggemann

Breiteneder

2000

Int Arch Allergy Immunol

View full text Add to dashboard Cite

Natural rubber is a component of the latex of the tropical Hevea brasiliensis tree which is widely used in the manufacturing of medical devices and a large variety of articles for everyday use. Over a dozen allergens have been identified in the latex of H. brasiliensis. The allergens Hev b 1, Hev b 3, Hev b 6, and Hev b 7 are proteins that are involved in the biosynthesis of rubber or the coagulation of latex. Allergens that are part of the plant’s defense system are represented by Hev b 2 and class I endochitinases. The allergens Hev b 4, Hev b 5, and Hev b 8–10 were classified as either structural or housekeeping proteins. Immediate-type hypersensitivity reactions to proteins present in Hevea latex were first described in 1927. Since then, natural rubber latex (NRL) allergy has become an important medical problem for an increasing number of individuals. Sensitization mainly occurs by wound or mucosal contact with NRL devices during surgery or by inhalation of airborne allergens released from powdered latex gloves. The number of surgical interventions and an atopic disposition are the most important risk factors for developing latex allergy, especially in children with spina bifida. Exposure to NRL products should be carefully avoided for individuals who belong to high-risk groups. Initial studies on establishing a latex-free environment for surgery in all spina bifida patients have reported on a decrease in sensitization and allergy to NRL.

show abstract

“…Latex allergy has been increasingly reported in the American literature as a cause of severe intra-operative anaphylaxis [1][2][3][4], but has received less attention in the British press [S]. Many British anaesthetists are unfamiliar with the condition, and may be taken by surprise on encountering it for the first time.…”

Section: Introductionmentioning

confidence: 99%

Latex allergy: an unfamiliar cause of intra‐operative cardiovascular collapse

Hodgson

Andersen

1994

Anaesthesia

View full text Add to dashboard Cite

SummaryWe describe severe latex allergy in an 8-year-old girl undergoing elective orthopaedic surgery and anaesthesia. Sudden, profound cardiorespiratory collapse occurred 40 min after induction. During the I h period of resuscitation the child required a total of 14.5 rnl adrenaline I in 10 000. A subsequent latex radioallergosorbent test was very strongly positive. Two weeks later the child presented again for surgery. Neoprene surgical gloves were used and all latex products eliminated from the anaesthetic equipment. Latex contact was strictly avoided during drug preparation and administration. This time the intra-operative course was unevenrful. Key wordsComplications; anaphylaxis, latex.Latex allergy has been increasingly reported in the American literature as a cause of severe intra-operative anaphylaxis [1][2][3][4], but has received less attention in the British press [S]. Many British anaesthetists are unfamiliar with the condition, and may be taken by surprise on encountering it for the first time. Case historyAn 8-year-old girl with cerebral palsy, weighing 25 kg, presented for adductor tendon release and femoral osteotomy. She was quadriplegic, blind, and received fluids via a gastrostomy tube following many episodes of inhalational pneumonitis. She had undergone two uneventful orthopaedic procedures at other centres. A pre-operative history of allergy to grass pollen was obtained and her family volunteered that she had developed mild peri-orbital oedema after the taping of her eyes during a previous operation. There was no history of allergy to rubber products or of repeated urinary catheterisation.Anaesthesia was induced by inhalation of oxygen, nitrous oxide and halothane from a clear plastic mask. Cricoid pressure was applied, and, after putting in a venous cannula, suxamethonium 40 mg and atropine 0.2 mg were given. After intubation of the trachea, paralysis was maintained with atracurium lOmg, and morphine 2mg and cefazolin 500 mg were given.Forty minutes later the Spo, decreased abruptly from 98% to < 70% over approximately 10 s. Simultaneously, the end-tidal CO, decreased to 15mmHg, the systolic blood pressure decreased to SOmmHg, the heart rate increased to 140, and the chest would not move on attempting to hand ventilate with 100% oxygen. Surgery was stopped. Total obstruction of the tracheal tube was considered and the child's trachea was rapidly reintubated, although the original tube had proved patent. Severe anaphylaxis was then suspected, despite the length of time since induction and the absence of any recent boluses of drugs. Adrenaline 2.5 ml 1 in 10000 given intravenously resulted in temporary relief of the intense bronchospasm. Albumin 5% (500ml) was given by rapid intravenous infusion. Over the next hour the child developed widespread cutaneous flushing and peri-orbital oedema. Repeated boluses of adrenaline, to a total of 12 ml of 1 in 10 000, were required in order to maintain an Spo, > go%, a peak inspiratory pressure c 50 cmH,O, and a systolic blood pressure > 60 mmHg. The pa...

show abstract

Intraoperative anaphylaxis to latex

Abstract: Intraoperative anaphylaxis to latex

Cited by 57 publications

References 16 publications

Hypersensitivity to natural rubber: a potentially life‐threatening complication under anaesthesia

Hypersensitivity to natural rubber: a potentially life‐threatening complication under anaesthesia

Latex Allergy in Children

Latex allergy: an unfamiliar cause of intra‐operative cardiovascular collapse

Contact Info

Product

Resources

About