A Pilot Study to Assess Safety and Feasibility of Intrathecal Immunoglobulin for the Treatment of Adults with Tetanus
| Autor: | C. Louise Thwaites, Lam Minh Yen, Ha Thi Hai Duong, Nguyen Van Vinh Chau, Pham Thi Lieu, Huynh Thi Loan, Le Van Tan, Ronald B. Geskus, Duong Bich Thuy, H. Rogier van Doorn, Nguyen Van Hao, Nguyen Thi Hoang Mai, Evelyne Kestelyn, Nguyen Thi Phuong Dung, Guy E. Thwaites, Nguyen Hoan Phu, Tran Tan Thanh, Nicholas P. J. Day, Tran Tinh Hien, Duncan Wyncoll |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_treatment Deep vein 030231 tropical medicine Immunoglobulins Pilot Projects Tetanus Antitoxin law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Virology medicine Humans 030212 general & internal medicine Adverse effect Injections Spinal Randomized Controlled Trials as Topic Mechanical ventilation Tetanus medicine.diagnostic_test Lumbar puncture business.industry Articles Length of Stay Middle Aged medicine.disease Intensive care unit 3. Good health Intensive Care Units Treatment Outcome Infectious Diseases medicine.anatomical_structure Anesthesia Feasibility Studies Parasitology Antitoxin business |
| Zdroj: | The American Journal of Tropical Medicine and Hygiene |
| ISSN: | 1476-1645 0002-9637 |
| Popis: | 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: | OpenAIRE |
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