Post-neonatal tetanus: issues in intensive care management.
Indian J Pediatr
;
2001 Mar; 68(3): 267-72
Article
in English
| IMSEAR
| ID: sea-84475
ABSTRACT
Tetanus is an acute neurological disease characterized by muscle rigidity and spasms, autonomic dysfunction and in severe forms requires respiratory and hemodynamic support. Though it is entirely preventable by immunization, it still occurs in developing countries causing significant morbidity and mortality. Intensive care management of tetanus is fraught with problems of ventilator-associated pneumonia, nosocomial sepsis and a variety of other complications. Various treatment protocols have been tried in managing diverse manifestations of severe tetanus but the consensus is yet to emerge. In this review we have discussed the pathophysiology, clinical features and management controversies and suggest on basis of our experience use of high dose diazepam (20-120 mg/kg/day) and vecuronium with mechanical ventilation if required for control of spasms, and early detection of autonomic dysfunction and use of propranolol, in our circumstances.
Full text:
Available
Index:
IMSEAR (South-East Asia)
Main subject:
Tetanus
/
Female
/
Humans
/
Male
/
Child
/
Child, Preschool
/
Critical Care
/
Diazepam
/
Muscle Relaxants, Central
Type of study:
Practice guideline
/
Screening study
Language:
English
Journal:
Indian J Pediatr
Year:
2001
Type:
Article
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