The role of the anaesthesiologist in the management of severe systemic tetanus

Crandell, D. LeRoy; Hollandsworth, L. C.; Whitcher, Charles E.

doi:10.1007/bf03014192

Cited by 5 publications

(3 citation statements)

References 5 publications

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“…The initial reports of the use of neuromuscular blockade and mechanical ventilation that appeared in the 1950s followed experience gained from using these techniques during the poliomyelitis epidemics. 10 Prior to the use of these techniques, respiratory failure from the muscle paroxysms was the primary cause of death from tetanus.…”

Section: Discussionmentioning

confidence: 99%

Perioperative care of a child with tetanus

Schloss

Cambier

Tobias

2011

Southern African Journal of Anaesthesia and Analgesia

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Section: Discussionmentioning

confidence: 99%

Perioperative care of a child with tetanus

Schloss

Cambier

Tobias

2011

Southern African Journal of Anaesthesia and Analgesia

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“…Historically, anesthesiologists have been involved in tetanus management for their expertise in pharmacologic muscle relaxation, tracheal intubation, and mechanical ventilation. 15 Following their experience in the poliomyelitis epidemics in Copenhagen in 1952, Ibsen and Lassen applied new muscle relaxation techniques with mechanical ventilation to tetanus patients. 15 Prior to this, hypoventilatory respiratory failure from muscle paroxysms was the major cause of death from tetanus.…”

Section: Management Of Established Tetanusmentioning

confidence: 99%

“…15 Following their experience in the poliomyelitis epidemics in Copenhagen in 1952, Ibsen and Lassen applied new muscle relaxation techniques with mechanical ventilation to tetanus patients. 15 Prior to this, hypoventilatory respiratory failure from muscle paroxysms was the major cause of death from tetanus. 5 Baker recognized the autonomic instability which develops in tetanus as early as 1942.…”

Section: Management Of Established Tetanusmentioning

confidence: 99%

Tetanus in developing countries: a case series and review

Gibson

Uwineza

Kiviri

et al. 2009

Can J Anesth/J Can Anesth

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Purpose Few anesthesiologists have expertise in the diagnosis and treatment of tetanus, a disease that remains prevalent in developing countries. We report on a series of four cases of tetanus cases recently encountered in Rwanda. We review the clinical epidemiology, pathophysiology, diagnosis and the treatment of tetanus, and provide implications for anesthesiologists and critical care physicians. Clinical features We report four cases, two involving adults who were inadequately vaccinated and experienced injuries, and two involving neonates, both of whom underwent umbilical cord transection using unsterilized equipment. All patients required tracheal intubation, and were mechanically ventilated when equipment was available. One adult and one neonate succumbed to the disease. These cases highlight the difficulties of diagnosis and management of complicated diseases in the resourcechallenged health care setting of developing countries. Conclusions The differential diagnosis of tetanus may be confusing, and survival depends on the rapidity of treatment with antitoxin, as well as adequate supportive care. High doses of sedatives and muscle relaxants, as well as prolonged mechanical ventilation, are usually necessary. Mortality remains high, usually resulting from late respiratory failure and cardiovascular collapse, associated with autonomic instability. Anesthesiologists and critical care physicians have an important role to play in the management of these patients. Increased involvement in humanitarian health organizations, immigration from developing countries, and emergence of high risk groups in developed countries will likely result in more exposure of anesthesiologists to the complexities of this disease. RésuméObjectif Tre`s peu d'anesthe´siologistes sont experts du diagnostic et du traitement du te´tanos, une pathologie qui demeure pre´valente dans les pays en voie de de´veloppe-ment. Nous rapportons une se´rie de quatre cas de te´tanos survenus re´cemment au Rwanda. Nous passons en revue l'e´pide´miologie clinique, la physiopathologie, le diagnostic et le traitement du te´tanos, et proposons des pistes inte´-ressantes pour les anesthe´siologistes et les me´decins en soins critiques. É léments cliniques Nous rapportons quatre cas dont deux impliquent des adultes mal vaccine´s et qui ont subi des blessures, et deux concernent des nouveaux-ne´s, tous deux ayant subi une coupe transversale du cordon ombilical a`l'aide d'instruments non ste´rilise´s. Tous les patients ont ne´cessite´une intubation trache´ale et ont e´te´venti-le´s me´caniquement lorsque le mate´riel e´tait disponible. Ces cas soulignent les difficulte´s rencontre´es lors du diagnostic et de la prise en charge de pathologies complexes dans le contexte des soins de sante´manquant de ressources des pays en voie de de´veloppement. Conclusions Le diagnostic diffe´rentiel du te´tanos peut porter a`confusion, et la survie de´pend de la rapidite´du traitement avec de l'antitoxine ainsi que de soins d'accompagnement adapte´s. En ge´ne´ral, des...

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The role of the anaesthesiologist in the management of severe systemic tetanus

Cited by 5 publications

References 5 publications

Perioperative care of a child with tetanus

Perioperative care of a child with tetanus

Tetanus in developing countries: a case series and review

Meprobamate-like Agents Bibliographies

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