DO LATEX PRECAUTIONS IN CHILDREN WITH MYELODYSPLASIA REDUCE INTRAOPERATIVE ALLERGIC REACTIONS

Children with myelodysplasia have an increased incidence of latex alle rgy, which can lead to severe intraoperative allergic reactions. Despi te widespread recommendations to avoid intraoperative latex exposure, little evidence exists to support the efficacy of this practice. We ex amined the incidence of intraoperative allergic reactions in children with myelodysplasia who underwent 1,025 operations in a 36-month perio d before and after institution of a standardized latex avoidance proto col. Risk factors for an intraoperative reaction were found to be a hi story of latex allergy (p = 0.001) and surgery performed before instit ution of the latex-avoidance protocol (p = 0.01) The estimate of incre ased risk for allergic reaction was 3.09 times higher in cases perform ed without latex avoidance. Recognized violation of the protocol after its institution led to severe allergic reactions in three patients. O ur experience suggests that a latex-avoidance protocol reduces intraop erative allergic reactions in children with myelodysplasia. Developmen t of severe allergic reactions with violation of the protocol reinforc es the importance of vigilance on the part of all operating room perso nnel in its implementation.