Journal article
Management of Reyeʼs syndrome: A rational approach to a complex problem
Critical care medicine, Vol.5(5), pp.234-238
09/1977
DOI: 10.1097/00003246-197709000-00005
PMID: 902493
Abstract
Five patients suffering from progressive Reyeʼs syndrome were aggressively treated in our ICU. Our protocol consisted of endotracheal intubation, curarization, mechanical ventilation, hypothermia to 31°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.
Details
- Title: Subtitle
- Management of Reyeʼs syndrome: A rational approach to a complex problem
- Creators
- AZMY BOUTROS - Departments of Anesthesia (Intensive Care Unit), Surgery (Division of Neurosurgery), and Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, IA 52242. Dr. Boutros is Professor of Anesthesiology and Director of ICU. His present address is: Chairman, Division of Anesthesiology, The Cleveland Clinic Foundation, Cleveland, OH 44106. Dr. Hoyt is Associate Professor of Anesthesiology and Associate Director of ICU. His present address is: 18412 Springcrest Drive, Minnetonka, MN 55343. Dr. Menezes is Assistant Professor of Neurosurgery. Dr. Bell is Professor of Pediatrics and NeurologyJOHN HOYTARNOLD MENEZESWILLIAM BELL
- Resource Type
- Journal article
- Publication Details
- Critical care medicine, Vol.5(5), pp.234-238
- Publisher
- Williams & Wilkins
- DOI
- 10.1097/00003246-197709000-00005
- PMID
- 902493
- ISSN
- 0090-3493
- eISSN
- 1530-0293
- Language
- English
- Date published
- 09/1977
- Academic Unit
- Stead Family Department of Pediatrics; Neurosurgery; Otolaryngology
- Record Identifier
- 9984040588802771
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