tailieunhanh - Báo cáo y học: "Prolonged high-dose intravenous magnesium therapy for severe tetanus in the intensive care unit: a case series"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài:Prolonged high-dose intravenous magnesium therapy for severe tetanus in the intensive care unit: a case series | Karanikolas et al. Journal of Medical Case Reports 2010 4 100 http content 4 1 100 jA CASE REPORTS CASE REPORT Open Access Prolonged high-dose intravenous magnesium therapy for severe tetanus in the intensive care unit a case series Menelaos Karanikolas 1 Dimitrios Velissaris1 Markos Marangos2 Vassilios Karamouzos1 Fotini Fligou1 and Kriton S Filos1 Abstract Introduction Tetanus rarely occurs in developed countries but it can result in fatal complications including respiratory failure due to generalized muscle spasms. Magnesium infusion has been used to treat spasticity in tetanus and its effectiveness is supported by several case reports and a recent randomized controlled trial. Case presentations Three Caucasian Greek men aged 30 50 and 77 years old were diagnosed with tetanus and admitted to a general 12-bed intensive care unit in 2006 and 2007 for respiratory failure due to generalized spasticity. Intensive care unit treatment included antibiotics hydration enteral nutrition early tracheostomy and mechanical ventilation. Intravenous magnesium therapy controlled spasticity without the need for additional muscle relaxants. Their medications were continued for up to 26 days and adjusted as needed to control spasticity. Plasma magnesium levels which were measured twice a day remained in the 3 to mmol L range. We did not observe hemodynamic instability arrhythmias or other complications related to magnesium therapy in these patients. All patients improved came off mechanical ventilation and were discharged from the intensive care unit in a stable condition. Conclusion In comparison with previous reports our case series contributes the following meaningful additional information intravenous magnesium therapy was used on patients already requiring mechanical ventilation and remained effective for up to 26 days significantly longer than in previous reports without significant toxicity in two patients. The overall .

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