A Pilot Study to Assess Safety and Feasibility of Intrathecal Immunoglobulin for the Treatment of Adults with Tetanus.

Autor:	Loan HT; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Yen LM; Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Kestelyn E; Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom.; Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Hao NV; University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Mai NTH; Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Thuy DB; Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Duong HTH; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Dung NTP; Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Phu NH; Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Lieu PT; Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Thanh TT; Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Geskus R; Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom.; Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., van Doorn HR; Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom.; Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Tan LV; Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Wyncoll D; Guy's and St. Thomas' Hospitals NHS Trust, London, United Kingdom., Day NPJ; Mahidol Oxford Research Unit, Bangkok, Thailand.; Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom., Hien TT; Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom.; Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Thwaites GE; Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom.; Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Chau NVV; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Thwaites CL; Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom.; Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
Jazyk:	angličtina
Zdroj:	The American journal of tropical medicine and hygiene [Am J Trop Med Hyg] 2018 Aug; Vol. 99 (2), pp. 323-326. Date of Electronic Publication: 2018 Jun 14.
DOI:	10.4269/ajtmh.18-0153
Abstrakt:	Tetanus remains a significant burden in many low- and middle-income countries. The tetanus toxin acts within the central nervous system and intrathecal antitoxin administration may be beneficial, but there are safety concerns, especially in resource-limited settings. We performed a pilot study to assess the safety and feasibility of intrathecal human tetanus immunoglobulin in five adults with tetanus before the conduct of a large randomized controlled trial. Intrathecal injection via lumbar puncture was given to all patients within a median 140 (range 100-165) minutes of intensive care unit (ICU) admission. There were no serious adverse effects associated with the procedure although three patients had probably related minor adverse events which resolved spontaneously. Median ICU length of stay was 14 (range 5-17) days. Two patients required mechanical ventilation and one developed a deep vein thrombosis. Within 240 days of hospital discharge, no patients died and all patients returned to work.
Databáze:	MEDLINE
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