Anaphylactic shock during hyperbaric oxygen therapy

Area of Science:

• Allergy and Immunology
• Hyperbaric Medicine
• Emergency Medicine

Background:

• Hyperbaric oxygen therapy (HBOT) is a treatment involving breathing pure oxygen in a pressurized chamber.
• Patients undergoing HBOT may have pre-existing conditions, including allergies, that require careful consideration.
• Latex allergy is a growing concern, with potential for severe reactions in various medical settings.

Observation:

• A 38-year-old woman with a history of oral-allergy syndrome and latex sensitivity developed anaphylaxis during HBOT.
• Symptoms included malaise, anxiety, dyspnea, tachycardia, cold sweating, and laryngeal stridor, commencing 15 minutes into compression.
• Facial angioedema persisted for several days despite intensive care management.

Findings:

• Diagnostic tests, including radioallergosorbent test (RAST) and prick tests, implicated latex as the cause of the anaphylactic reaction.
• This is reportedly the first extensive case report of a latex-induced anaphylactic reaction within a hyperbaric chamber.
• The patient's pre-existing sensitivities to certain fruits (oral-allergy syndrome) and latex were key historical factors.

Implications:

• Healthcare providers must conduct thorough patient histories to identify potential allergens before HBOT.
• The establishment of latex-safe hyperbaric chambers is crucial for managing patients with latex allergies.
• Maintaining readily accessible emergency kits is essential for managing severe allergic reactions during HBOT.