Potério Glória Maria Braga, Braga Angélica de Fátima de Assunção, Santos Regina Maria da Silva Feu, Gomes Ilka de Fátima Santana Ferreira Boin, Luchetta Maria Inez
Departamento de Anestesiologia da FCM/UNICAMP.
Rev Bras Anestesiol. 2009 Mar-Apr;59(2):210-8. doi: 10.1590/s0034-70942009000200009.
Latex allergy is becoming increasingly more frequent, affecting patients and health care professionals. The objective of this report was to present the case of a child with allergy to latex, who developed anaphylaxis during anesthesia for renal transplantation, and emphasize some of the multidisciplinary conducts used to decrease the risk of anaphylactic shock after graft reperfusion.
A male child, 5 years and 10 months old, P3 by the ASA classification, with a history of allergy to latex diagnosed after contact with balloons and confirmed by Rast test specific for latex and Prick test, underwent renal transplantation of a live donor graft for end-stage renal disease secondary to urologic malformation. The protocols for patients with Latex Allergy adopted by the Anesthesiology and Nursing Departments of the Hospital das Clínicas da UNICAMP were observed to avoid exposure of the child to latex. They started the day before the surgery by cleaning the operating rooms and substituting of all medical-hospital products by latex-free material. The equipment and materials used during the procedure were latex-free according to a technical report provided by the manufacturers. The surgery was done under general anesthesia and controlled mechanical ventilation. At the end of the surgery, the patient required blood transfusion, which was administered by a pressurizer; he developed cutaneous rash and the blood transfusion was discontinued, hydrocortisone was administered, and the infusion of crystalloids was increased. The child had an immediate and satisfactory response to the treatment.
Latex allergy has become a public health problem and the knowledge of specific therapeutic conducts allows immediate treatment and decreases patient risks.
乳胶过敏日益常见，影响患者及医护人员。本报告旨在呈现一例乳胶过敏儿童病例，该患儿在肾移植麻醉期间发生过敏反应，并强调为降低移植肾再灌注后过敏性休克风险所采用的一些多学科措施。
一名5岁10个月大的男童，ASA分级为P3，有乳胶过敏史，在接触气球后被诊断出乳胶过敏，并经乳胶特异性Rast试验和点刺试验确诊。因泌尿系统畸形继发终末期肾病，接受了活体供肾移植。为避免患儿接触乳胶，遵循了坎皮纳斯大学临床医院麻醉科和护理部采用的乳胶过敏患者诊疗方案。从手术前一天开始，清洁手术室，用无乳胶材料替换所有医疗用品。根据制造商提供的技术报告，手术过程中使用的设备和材料均为无乳胶产品。手术在全身麻醉和控制机械通气下进行。手术结束时，患者需要输血，通过加压输血器进行；他出现了皮疹，输血停止，给予氢化可的松，并增加晶体液输注。患儿对治疗立即产生了满意的反应。
乳胶过敏已成为一个公共卫生问题，了解特定的治疗措施可实现即时治疗并降低患者风险。
