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Hypotension in tetanus.

J L Corbett, J M Spalding, P J Harris

    British Medical Journal
    |August 25, 1973
    PubMed
    Summary
    This summary is machine-generated.

    Severe tetanus can cause sudden, profound hypotension unrelated to shock or fluid imbalance. This may indicate impaired autonomic nervous system function and baroreceptor reflexes in tetanus patients.

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    Area of Science:

    • Neurology
    • Critical Care Medicine

    Background:

    • Severe tetanus can present with complex physiological disturbances.
    • Autonomic nervous system dysfunction is a known complication of tetanus.

    Purpose of the Study:

    • To characterize profound arterial hypotension in severe tetanus.
    • To investigate the potential link between tetanus and autonomic dysfunction.

    Main Methods:

    • Continuous intra-arterial blood pressure monitoring in three severe tetanus patients.
    • Inclusion of heart rate, central venous pressure, cardiac output, and blood gas measurements.
    • Clinical observation for signs of shock and fluid balance disturbances.

    Main Results:

    • Episodes of profound hypotension (as low as 32/16 mm Hg) lasting minutes to hours were observed.

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  • Hypotension was not associated with peripheral vasoconstriction, tachycardia, or fluid imbalance.
  • Abrupt onset and termination of hypotensive episodes, sometimes triggered by stimuli like tracheal aspiration.
  • Heart rate decreased, and central venous pressure did not increase during hypotension.

    • Conclusions:

    • The observed hypotension in severe tetanus may represent a distinct clinical entity.
    • These episodes suggest a potential impairment of autonomic nervous activity, including baroreceptor reflexes, in tetanus.