Polio medical therapy: Difference between revisions
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==Overview== | ==Overview== | ||
There is no | There is no treatment for neither form of poliomyelitis. Current management of these patients is based on supportive care towards [[symptom]] relief and prevention of [[complications]]. Supportive treatment may include: application of hot moist patches to affected [[muscles]]; [[mechanical ventilation]] with tank respirators, or positive pressure ventilators; drainage and suction of [[secretions]]; [[bladder]] [[catheterization]]; physical and psychological therapy.<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> | ||
== Medical Therapy== | == Medical Therapy== | ||
===Supportive Care=== | ===Supportive Care=== | ||
Hospitalization is indicated for acute cases of paralytic poliomyelitis, since bed rest | Hospitalization is indicated for acute cases of paralytic poliomyelitis, since bed rest and proper care help prevent extension of the [[paralysis]]. [[Pain]] and [[spasms]] may be relieved by application of hot 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> | [[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 - | * Tank respirators - used to treat patients with paralytic poliomyelitis in the past. Although not commonly used, some institutions still use these respirators in order to avoid [[tracheal intubation]] and the [[complications]] that may occur from it. | ||
* Positive-pressure ventilators - Although requiring tracheal intubation, these machines are replacing tank respirators, allowing better access to the patient. | * Positive-pressure ventilators - Although requiring [[tracheal intubation]][[]], these machines are replacing tank respirators, allowing better access to the patient. | ||
[[image:Tank respirator.png|200px|thumb|center|Artificial respirator commonly known as the iron lung <SMALL><SMALL>''[http://www.cdc.gov Adapted from Center for Disease Control and Prevention(CDC)]''<ref name="CDC">{{Cite web | title = Center for Disease Control and Prevention (CDC) | url = http://www.cdc.gov}}</ref></SMALL></SMALL>]] | [[image:Tank respirator.png|200px|thumb|center|Artificial respirator commonly known as the iron lung <SMALL><SMALL>''[http://www.cdc.gov Adapted from Center for Disease Control and Prevention(CDC)]''<ref name="CDC">{{Cite web | title = Center for Disease Control and Prevention (CDC) | url = http://www.cdc.gov}}</ref></SMALL></SMALL>]] | ||
For patients with bulbar poliomyelitis | For patients with bulbar poliomyelitis without [[respiratory]] [[muscle]] [[paralysis]], [[drainage]] of [[secretions]] may be accomplished by [[suction]] and postural drainage. For severe cases of this form of the disease, tracheal intubation may be required.<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> | ||
In spinal poliomyelitis | In spinal poliomyelitis with paralysis or weakness of the bladder muscle, [[catheterization]] may be indicated.<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> | ||
Psychological management of the disease should also be provided to the patient, in order to | Psychological management of the disease should also be provided to the patient, in order to facilitate dealing with the disease and accompanying disabilities.<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> | ||
==References== | ==References== | ||
Revision as of 18:12, 3 September 2014
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
There is no treatment for neither form of poliomyelitis. Current management of these patients is based on supportive care towards symptom relief and prevention of complications. Supportive treatment may include: application of hot moist patches to affected muscles; mechanical ventilation with tank respirators, or positive pressure ventilators; drainage and suction of secretions; bladder catheterization; physical and psychological therapy.[1]
Medical Therapy
Supportive Care
Hospitalization is indicated for acute cases of paralytic poliomyelitis, since bed rest and proper care help prevent extension of the paralysis. Pain and spasms may be relieved by application of hot 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 - used to treat patients with paralytic poliomyelitis in the past. Although not commonly used, some institutions still use these respirators in order to avoid tracheal intubation and the complications that may occur from it.
- Positive-pressure ventilators - Although requiring tracheal intubation[[]], these machines are replacing tank respirators, allowing better access to the patient.
For patients with bulbar poliomyelitis without respiratory muscle paralysis, drainage of secretions may be accomplished by suction and postural drainage. For severe cases of this form of the disease, tracheal intubation may be required.[5]
In spinal poliomyelitis with paralysis or weakness of the bladder muscle, catheterization may be indicated.[6]
Psychological management of the disease should also be provided to the patient, in order to facilitate dealing with the disease and accompanying disabilities.[7]
References
- ↑ 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.
- ↑ "Center for Disease Control and Prevention (CDC)".
- ↑ 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.