Survival of a patient with tetanus in Bhutan using a magnesium infusion managed only by clinical signs.

Autor: Wangmo KP; Department of Anaesthesiology, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan., Teng M; Division of Emergency Medicine, Department of Surgery, Stanford University School of Medicine, Stanford, CA., Henker R; School of Nursing, University of Pittsburgh, Pittsburgh, PA., Kinnear S; Flinders Medical Centre, Bedford Park, South Australia., Tshering J; Department of Anaesthesiology, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan., Wang NE; Division of Emergency Medicine, Department of Surgery, Stanford University School of Medicine, Stanford, CA.
Jazyk: angličtina
Zdroj: Wilderness & environmental medicine [Wilderness Environ Med] 2014 Jun; Vol. 25 (2), pp. 194-7. Date of Electronic Publication: 2014 Apr 30.
DOI: 10.1016/j.wem.2013.11.006
Abstrakt: Tetanus is a life-threatening disease that continues to have a high prevalence in developing countries. Severe muscle spasms often require patients to receive tracheostomy, high-dose sedatives, and sometimes prolonged neuromuscular blockade. Magnesium sulfate (MgSO4) infusion has great promise as an adjunct treatment for severe tetanus, as it may allow clinicians to decrease the dose of other sedative medications. Although the mechanism of action of MgSO4 is not well understood, it appears to attenuate both the muscle spasms and autonomic instability associated with severe tetanus infections. However, MgSO4 infusions are often managed based on serial measurements of serum magnesium levels and other laboratory tests such as arterial blood gases, which can be difficult to obtain in resource-poor settings. We describe a case of severe tetanus in Bhutan managed through the use of magnesium infusion titrated solely to physical examination findings.
(Copyright © 2014 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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