Continuous Monitoring of Intracranial Pressure in Reye's Syndrome ‐ 5 Years Experience

Ching‐Shiang ‐S Chi, King‐Lee ‐L Law, Tai-Tong Wong, Gwo‐Yuan ‐Y Su, Nung Lin

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Monitoring of intracranial pressure (ICP) and efforts to keep the ICP below the critical level are vital in the treatment of Reye's syndrome. Continuous monitoring of ICP was carried out in 21 cases of Reye's syndrome who were at or beyond stage III at the time of admission to the Veterans General Hospital, between January 1981 and August 1986. Seventeen had ICP ranging from 15mmHg to 67mmHg. Three patients died, 1 in stage V with an ICP of 67mmHg received a craniectomy, and 2 others were in stage IV with ICP's of 66mmHg and 25mmHg, respectively. The fatality rate was 14% (3/21). Among 18 patients, 5 had moderate psychomotor retardation (PMR), 4 had severe PMR and 2 had mild PMR. The remaining 7 patients survived without sequelae. Blood exchange transfusion could further reduce ICP and seemed to improve neurologic outcome. Blood ammonia higher than 400μg% is indicative of a bad prognosis. Hyperventilation was the most rapid and effective means of reducing moderate degrees of increased ICP. During intensive supportive care, we also found that coughing, endotracheal intubation, seizures, asynchronous respiration to an artificial respirator, suction of the airway and any painful stimulation caused further increases in ICP and worsened the situation. Care should be given to avoid these factors.

Original languageEnglish
Pages (from-to)426-434
Number of pages9
JournalPediatrics International
Volume32
Issue number4
DOIs
Publication statusPublished - Jan 1 1990
Externally publishedYes

    Fingerprint

Keywords

  • Blood exchange transfusion
  • Hypertonic glucose infusion.
  • Hyperventilation
  • Intracranial pressure monitoring
  • Reye's syndrome

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this