All issues > Volume 30(6); 1987

Case Report

J Korean Pediatr Soc. 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

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.

Keywords :Neonatal tetanus; IPPV ; Neuromuscular block ace