REYE’S

SYNDROME
ETIOLOGY
 
 Reye's syndrome (RS) is primarily a children's
disease, although it can occur at any age. It
occurs most commonly in children between
the ages of 4 and 12.

 Itaffects all organs of the body but is most

harmful to the brain and the liver--causing an
acute increase of pressure and inflammation
within the brain and, often, massive
accumulations of fat in the liver and other
organs, as well as causing hypoglycemia.
 CLINICAL MANIFESTATION
  

Stage I  Possible coma

 Persistent, heavy vomiting that is  Possible cerebral edema
not relieved by eating  Rarely, respiratory arrest

 Generalized lethargy  
 General mental symptoms, e.g. Stage IV
 Deepening coma
confusion
 Large pupils with minimal response to
 Nightmares
 light
High fever  Minimal

but still present hepatic
Headaches
dysfunction
 
 Stage II Stage V
 Stupor caused by minor brain  Very rapid onset following stage IV
inflammation  Deep coma
 Hyperventilation  Seizures
 Fatty liver (found by biopsy)  Multiple organ failure
 Hyperactive reflexes  Flaccidity
 Extremely high blood ammonia (above
300 mg/dL of blood)
 Stage III  Death
 Continuation of Stage I and II
symptoms
ASSESSMENT: DIAGNISTIC PROCEDURE
 
 Spinal tap (lumbar puncture)
 
 Liver biopsy
 
 Detecting rare metabolic disorders
  Lab Studies
Liver function testing
Bilirubin levels
prothrombin time (PT) and activated
partial thromboplastin time (aPTT)
Lipase and amylase levels
o Serum bicarbonate levels
BUN and creatinine levels
Hypoglycemia.
Serum glucose test
Urine specific gravity
  Imaging Studies
Head CT scanning, MRI

electroencephalogram (EEG)
MEDICAL MANAGEMENT
 Treatment is supportive as there is no cure for the illness.
Treatment focuses on making sure a child with Reye
syndrome maintains proper fluid and electrolyte balance,
nutritional, and cardio respiratory status. Mechanical
ventilation may be necessary if breathing becomes too
sluggish. Intracranial pressure and blood pressure may be
monitored.

Drug treatments may include:

 Intravenous fluids
 Insulin
 Corticosteroids
 Diuretics
NURSING MANAGEMENT
 Stage I
• Monitor vital signs and check level of consciousness
• Monitor fluid intake and output. Maintain urine output at
1.0ml/kg/hr; plasma osmolality 290mOsm; and blood glucose
150mg/ml (Goal: Keep glucose high, osmolality normal, ammonia
low).Also, restrict protein.

Stage II
• Watch for seizures and maintain precautions.
• Immediately report any signs of coma that require invasive,
supportive therapy, such as intubation.
• Keep head of bed at 30° angle.

Stage III
• Monitor ICP (should be <20 before suctioning) or give thiopental IV as
ordered, as necessary, hyperventilate the patient.
· If patient lapses into coma, immediately give 50%
dextrose in water IV as ordered.
• When ventilating the patient, maintain PCO2 between 23
and 30 mmHg and PO2 between 80 and 100 mmHg.
• Closely monitor cardiovascular status with pulmonary
artery catheter or central venous pressure line.
• Give good skin and mouth care and range-of-motion
exercises.

Stage IV
• Check patient for loss of reflexes and signs of flaccidity.
• Give the family the extra support they need, considering
their child’s poor prognosis.

Stage V
• Help the family to face the patient’s impending death.
PREVENTION

 Aspirin and other drugs from the

salicylate family should never be used in
the treatment of chickenpox, influenza,
and other viral diseases.

 In general, aspirin should not be used for

kids or teenagers except on the advice of
a doctor for certain conditions.