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The Indian Journal of Pediatrics

, Volume 68, Issue 3, pp 267–272 | Cite as

Post-neonatal tetanus: Issues in intensive care management

  • Sunit Singhi
  • Vivek Jain
  • C. Subramanian
Symposium: Intensive Care-I

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 autonomie dysfunction and use of propranolol, in our circumstances.

Key words

Post-neonatal tetanus Intensive care treatment Diazepam therapy Autonomie instability 

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Copyright information

© Dr. K C Chaudhuri Foundation 2001

Authors and Affiliations

  1. 1.Department of PediatricsAdvanced Pediatric Centre, Postgraduate Institute of Medical Education and ResearchChandigarhIndia

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