Polio medical therapy: Difference between revisions
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Hospitalization is indicated for acute cases of paralytic poliomyelitis, since bed rest prevents extension of paralysis. Pain and spasms may be relieved by application of host moist packs to the affected muscles. Once extension of paralysis has stopped, physical therapy should be initiated.<ref>{{cite book | last = Mandell | first = Gerald | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA | year = 2010 | isbn = 0443068399 }}</ref> | Hospitalization is indicated for acute cases of paralytic poliomyelitis, since bed rest prevents extension of paralysis. Pain and spasms may be relieved by application of host moist packs to the affected muscles. Once extension of paralysis has stopped, physical therapy should be initiated.<ref>{{cite book | last = Mandell | first = Gerald | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA | year = 2010 | isbn = 0443068399 }}</ref> | ||
[[Mechanical ventilation]] is indicated when [[paralysis]] of the [[respiratory]] muscles occurs, before development of [[hypoxia]]. It is often started once vital capacity is below 50%. Two respiratory machines are available for this purpose:<ref>{{cite book | last = Mandell | first = Gerald | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA | year = 2010 | isbn = 0443068399 }}</ref> | |||
* Tank Respirators - although not commonly used, some institutions use these respirators, that were used in the past to treat the same type of patients, in order to avoid tracheal intubation and the complications that may occur from it. | |||
* Positive-pressure Ventilators - Although they tracheal intubation, these machines are replacing tank respirators, allowing better access to the patient. | |||
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Pooling of secre- tions in the pharynx in mild bulbar poliomyelitis, if unaccompanied by spinal respiratory paralysis, can be managed with postural drainage and suction. Severe bulbar paralysis necessitates tracheal intubation. Weak- ness or paralysis of the bladder may necessitate catheterization. | |||
Management of long-term physical and psychiatric sequelae of paralytic poliomyelitis is beyond the scope of this text. The reader is referred to excellent older references on these topics.54,55 | Management of long-term physical and psychiatric sequelae of paralytic poliomyelitis is beyond the scope of this text. The reader is referred to excellent older references on these topics.54,55 | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Only treatment for symptoms is available, ranging from pain and fever relief to intubation and mechanical ventilation for patients with respiratory insufficiency.
Medical Therapy
There is no antiviral drug, or other kind of treatment for neither form poliomyelitis. Current management of these patients is based on supportive care towards symptom relief.[1]
Supportive Care
Hospitalization is indicated for acute cases of paralytic poliomyelitis, since bed rest prevents extension of paralysis. Pain and spasms may be relieved by application of host moist packs to the affected muscles. Once extension of paralysis has stopped, physical therapy should be initiated.[2]
Mechanical ventilation is indicated when paralysis of the respiratory muscles occurs, before development of hypoxia. It is often started once vital capacity is below 50%. Two respiratory machines are available for this purpose:[3]
- Tank Respirators - although not commonly used, some institutions use these respirators, that were used in the past to treat the same type of patients, in order to avoid tracheal intubation and the complications that may occur from it.
- Positive-pressure Ventilators - Although they tracheal intubation, these machines are replacing tank respirators, allowing better access to the patient.
- ↑ Mandell, Gerald (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0443068399.
- ↑ Mandell, Gerald (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0443068399.
- ↑ Mandell, Gerald (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0443068399.