Usefulness of Intermittent Positive-Pressure Respiration in the Treatment of Tetanus

Adams, E. B.; Holloway, R.; Thambiran, Aesen; Desai, Sonya

doi:10.1016/s0140-6736(66)90491-0

Cited by 22 publications

(5 citation statements)

References 2 publications

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“…Clifton [11] described 4 cases of severe tetanus in which fatal hypotension developed. Similar cases have been reported by Clark and Taylor [10] and Adams et al [1]. Prolonged sympathetic overactivity was suggested as the cause of the hypotension in these cases [11].…”

Section: Cardiovascular Disturbancessupporting

confidence: 88%

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The involvement of the sympathetic nervous system in tetanus

1979

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Besides the characteristic disturbances of the motor nervous system symptoms indicating an overactivity of the sympathetic nervous system can complicate the course of severe cases of tetanus. These symptoms include fluctuating tachycardia and hypertension, electrocardiographic changes, sweating, constipation with development of paralytic ileus and metabolic disorders. These symptoms are comparable to these developing in patients with phaeochromocytoma. Elevated catecholamine levels in plasma and urine have been found in several patients with tetanus who developed these symptoms. The prolonged over-activity of the sympathetic nervous system is thought to contribute to the still considerably high mortality rate. Myocardial lesions observed at necropsy are comparable to those found in patients dying of phaeochromocytoma. These lesions are suggested to be associated with sudden death from arrhythmias or cardiac failure in patients with tetanus. For the protection of the organism against the overactivity of the sympathetic nervous system a treatment using the combination of beta-adrenergic receptor blocking agents and adrenergic neuron blocking agents has been introduced. A reduction of the mortality rate was achievable by this treatment. Experimental evidence is accumulating that the tetanus toxin affects not only the motor, but also the sympathetic and sensory neurons.

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Section: Cardiovascular Disturbancessupporting

confidence: 88%

“…A further symptom which can develop in severe cases of tetanus is arterial hypotension which has often been preterminat [1,11]. Hypotension persisting for four days or lasting half to several hours and being resistant to noradrenaline and cortison was observed by Alhady et al [3] in several cases of tetanus.…”

Section: Cardiovascular Disturbancesmentioning

confidence: 95%

The involvement of the sympathetic nervous system in tetanus

1979

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“…Many episodes of cardiovascular instability occur in tetanus patients without identifiable cause (Lassen et al, 1954;Adams et al, 1966;Ablett, 1967). Prys-Roberts and Greenbaum (1967) found a hyperdynamic state in severe tetanus cases which was compatible with increased catecholamine activity.…”

Section: In Summarymentioning

confidence: 99%

Urinary Catecholamine Metabolite Concentrations in Tetanus

Toothill¹,

Dykes²,

Ablett³

1970

British Journal of Anaesthesia

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“…Atrakchi and Wilson (1977) estimate that about 22 to 25 cases occur in England and Wales per year. Present mortalities range from 80 to 20 per cent (Adams et al, 1966;Ganendran, 1974). The diagnosis of tetanus is usually easily made from the classical symptoms and signs, although these may be absent during the early stages of the disease and a traumatic lesion is not necessarily found (Macrae, 1974;Scott, 1980;Beaty, 1983;Watanabe et al, 1984).…”

Section: Discussionmentioning

confidence: 99%