The management of tetanus in adults in an intensive care unit in Southern Vietnam
<strong>Background:</strong> Tetanus remains common in many low- and middle-income countries (LMICs) yet the evidence base guiding management of this disease is extremely limited, particularly with respect to contemporary management options. Sharing knowledge about practice may facilitat...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Formato: | Journal article |
| Idioma: | English |
| Publicado: |
F1000Research
2021
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| _version_ | 1826307490357182464 |
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| author | Hao, NV Yen, LM Davies-Foote, R Trung, TN Duoc, NVT Trang, VTN Nhat, PTH Duc, DH Anh, NTK Lieu, PT Thuy, TTD Thuy, DB Phong, NT Truong, NT Thanh, PB Tam, DTH Puthucheary, Z Thwaites, CL |
| author_facet | Hao, NV Yen, LM Davies-Foote, R Trung, TN Duoc, NVT Trang, VTN Nhat, PTH Duc, DH Anh, NTK Lieu, PT Thuy, TTD Thuy, DB Phong, NT Truong, NT Thanh, PB Tam, DTH Puthucheary, Z Thwaites, CL |
| author_sort | Hao, NV |
| collection | OXFORD |
| description | <strong>Background:</strong> Tetanus remains common in many low- and middle-income countries (LMICs) yet the evidence base guiding management of this disease is extremely limited, particularly with respect to contemporary management options. Sharing knowledge about practice may facilitate improvement in outcomes elsewhere.
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<strong>Methods:</strong> We describe clinical interventions and outcomes of 180 adult patients ≥16 years-old with tetanus enrolled in prospective observational studies at a specialist infectious diseases hospital in Southern Vietnam. Patients were treated according to a holistic management protocol encompassing wound-care, antitoxin, antibiotics, symptom control, airway management, nutrition and de-escalation criteria.
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<strong>Results:</strong> Mortality rate in our cohort was 2.8%, with 90 (50%) patients requiring mechanical ventilation for a median 16 [IQR 12-24] days. Median [IQR] duration of ICU stay was 15 [8-23] days. Autonomic nervous system dysfunction occurred in 45 (25%) patients. Hospital acquired infections occurred in 77 (43%) of patients.
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<strong>Conclusion:</strong> We report favourable outcomes for patients with tetanus in a single centre LMIC ICU, treated according to a holistic protocol. Nevertheless, many patients required prolonged intensive care support and hospital acquired infections were common. |
| first_indexed | 2024-03-07T07:03:51Z |
| format | Journal article |
| id | oxford-uuid:dac4ac8c-76b9-40e7-857d-88fb6fb8fb0f |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T07:03:51Z |
| publishDate | 2021 |
| publisher | F1000Research |
| record_format | dspace |
| spelling | oxford-uuid:dac4ac8c-76b9-40e7-857d-88fb6fb8fb0f2022-04-13T10:52:02ZThe management of tetanus in adults in an intensive care unit in Southern VietnamJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:dac4ac8c-76b9-40e7-857d-88fb6fb8fb0fEnglishSymplectic ElementsF1000Research2021Hao, NVYen, LMDavies-Foote, RTrung, TNDuoc, NVTTrang, VTNNhat, PTHDuc, DHAnh, NTKLieu, PTThuy, TTDThuy, DBPhong, NTTruong, NTThanh, PBTam, DTHPuthucheary, ZThwaites, CL<strong>Background:</strong> Tetanus remains common in many low- and middle-income countries (LMICs) yet the evidence base guiding management of this disease is extremely limited, particularly with respect to contemporary management options. Sharing knowledge about practice may facilitate improvement in outcomes elsewhere. <br> <strong>Methods:</strong> We describe clinical interventions and outcomes of 180 adult patients ≥16 years-old with tetanus enrolled in prospective observational studies at a specialist infectious diseases hospital in Southern Vietnam. Patients were treated according to a holistic management protocol encompassing wound-care, antitoxin, antibiotics, symptom control, airway management, nutrition and de-escalation criteria. <br> <strong>Results:</strong> Mortality rate in our cohort was 2.8%, with 90 (50%) patients requiring mechanical ventilation for a median 16 [IQR 12-24] days. Median [IQR] duration of ICU stay was 15 [8-23] days. Autonomic nervous system dysfunction occurred in 45 (25%) patients. Hospital acquired infections occurred in 77 (43%) of patients. <br> <strong>Conclusion:</strong> We report favourable outcomes for patients with tetanus in a single centre LMIC ICU, treated according to a holistic protocol. Nevertheless, many patients required prolonged intensive care support and hospital acquired infections were common. |
| spellingShingle | Hao, NV Yen, LM Davies-Foote, R Trung, TN Duoc, NVT Trang, VTN Nhat, PTH Duc, DH Anh, NTK Lieu, PT Thuy, TTD Thuy, DB Phong, NT Truong, NT Thanh, PB Tam, DTH Puthucheary, Z Thwaites, CL The management of tetanus in adults in an intensive care unit in Southern Vietnam |
| title | The management of tetanus in adults in an intensive care unit in Southern Vietnam |
| title_full | The management of tetanus in adults in an intensive care unit in Southern Vietnam |
| title_fullStr | The management of tetanus in adults in an intensive care unit in Southern Vietnam |
| title_full_unstemmed | The management of tetanus in adults in an intensive care unit in Southern Vietnam |
| title_short | The management of tetanus in adults in an intensive care unit in Southern Vietnam |
| title_sort | management of tetanus in adults in an intensive care unit in southern vietnam |
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