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Neonatal Tetanus Treated with Intermittent Positive-Pressure Ventilation.

Journal of the Korean Pediatric Society 1987;30(6):671-676.
Published online June 30, 1987.
Neonatal Tetanus Treated with Intermittent Positive-Pressure Ventilation.
Ran Namgung1, Chuhl Joo Lyu1, Chul Lee1, Youn Ha Kang2, Dong Gwan Han1
1Department of Pediatrics, College of Medicine, Yonsei University, Seoul, Korea
2Department of Pediatrics, Kang Nam General Hospital, Public Corporation
인공호흡기로 치료한 신생아 파상풍 2례
남궁란1, 유철주1, 이 철1, 강연하2, 한동관1
1연세대학교 의과대학 소아과학교실
2지방공사 강남병원 소아과
Abstract
We report our experience with Neonatal Tetanus treated with Intermittent Positive-Pressure Ventilation combined with Neuromuscular blockade and high dose diazepam. Duration of mechanical ventilation was ranged from 15 days in case 1 to 36 days in case 2. Pneumonia with atelectasis and sepsis due to pseudomonas cepacia was complicated in case 2, but cleared up with sensitive antibiotics and vigorous physiotherapy. Muscle relaxation and sedation were achived by continuous IV infusion of high dose diazepam (20-40 mg/kg/day). Additional bolus injections of diazepam were administered if spasms was severe and frequent. Mioblock (0.05 mg/kg/dose) was given intravenously every three to four hours as needed to control muscle rigidity and to allow smooth ventilatory control. We thought that severe neonatal tetanus was best treated by IPPV with mioblock and high dose diazepam. A brief review of the related literature is given.
Key Words: Neonatal tetanus, IPPV , Neuromuscular block ace


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