Metabolic requirements in tetanus.
OBJECTIVE
To measure the metabolic requirements of patients with severe tetanus who require mechanical ventilation.


METHODS
Prospective, consecutive, open study using routine monitoring.


METHODS
A multidisciplinary ICU in a large teaching hospital.


METHODS
Five consecutive patients (age range 30 to 54 yrs) with severe tetanus. Four patients had clinical evidence of sympathetic nervous system overactivity.


METHODS
All patients were mechanically ventilated and appropriately treated for severe tetanus. Sympathetic nervous system overactivity was reduced by the administration of sedatives.


RESULTS
Measurements of metabolic rates were made using an indirect calorimetry device. Each of the five patients had three 8-hr periods of continuous metabolic monitoring for each of three levels of daily enteral nutritional support. The measured metabolic rates varied from 1310 to 2050 kcal/24 hrs (predicted 1280 to 1770 kcal/24 hrs). The variations from predicted basal metabolic rates varied from -6.3% to +10.5%.


CONCLUSIONS
The measured metabolic rates of patients with severe tetanus who are appropriately sedated are relatively constant and are within 10.5% of the predicted basal metabolic rates.
Linton
D M
DM
Department of Anaesthetics, Groote Schuur Hospital, Cape Town, South Africa.
Wells
Y
Y
Potgieter
P D
PD
D000328:Adult; D001481:Basal Metabolism; D003422:Critical Care; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009751:Nutritional Requirements; D011446:Prospective Studies; D013742:Tetanus / Q000378:metabolism* / Q000628:therapy