Document Detail


Management of Reye's syndrome. A rational approach to a complex problem.
MedLine Citation:
PMID:  902493     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Five patients suffering from progressive Reye's syndrome were aggressively treated in our ICU. Our protocol consisted of endotracheal intubation, curarization, mechanical ventilation, hypothermia to 31 degrees C, and fluid restriction. Intracranial pressure (ICP) was monitored and remained below 10-20 torr in all patients except one in whom ICP rose only once (for a few minutes) to 27 torr. Pulmonary artery wedge pressure was monitored in 4 patients and was maintained at 4-5 torr. Duration of active intervention as outlined above was 3-4 days. All 5 patients started with clinical stage IV and EEG grade IV or worse. Four patients had complete recovery and one died. In this group of patients, high ICP was not a feature of the disease. We recommend that use of mannitol for active dehydration be reserved for cases with proven rise in ICP, in which case hemodynamics should be carefully monitored.
Authors:
A Boutros; J Hoyt; A Menezes; W Bell
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Critical care medicine     Volume:  5     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:    1977 Sep-Oct
Date Detail:
Created Date:  1977-11-25     Completed Date:  1977-11-25     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  234-8     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Child
Child, Preschool
Female
Humans
Hypothermia, Induced
Intensive Care Units
Intracranial Pressure
Intubation, Intratracheal
Male
Respiration, Artificial
Reye Syndrome / drug therapy,  physiopathology,  therapy*
Tubocurarine / therapeutic use
Chemical
Reg. No./Substance:
57-95-4/Tubocurarine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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