Therapy
The cause of Reye’s syndrome cannot be treated directly. Therefore, the therapy is based on the treatment of the symptoms of the disease. The affected children usually have to be monitored by intensive care medicine.
Ventilation and sedation of the children is often necessary. The cerebral pressure must also be monitored. To reduce the cerebral edema and thus the intracranial pressure, mannitol can be given, for example. This is a substance that leads to increased dehydration and can reduce the fluid in the brain tissue. Elevated ammonia levels in the blood can be reduced by peritoneal dialysis, for example.
Prognosis
With a heavy development of the Reye syndrome it comes in approximately 3⁄4 of the cases to the death of the ill children. Therefore an early start of therapy in the early stages of the disease is of utmost importance. This can significantly reduce the high mortality rate.
Current studies assume an overall mortality rate of 25% for Reye syndrome. Approximately 1/3 of children develop permanent damage, such as neurological deficits or impaired speech and learning abilities. There is no direct prophylaxis to prevent the development of Reye syndrome. The only option is to refrain from using Aspirin® in children and adolescents with viral infections, as this is seen as the greatest risk factor for the disease.
Which medications are suitable for treating pain and fever in children?
Due to the existing assumption of a connection between Reye’s syndrome and the intake of Aspirin®, the administration of Aspirin® should definitely be avoided. For pain and fever, paracetamol and ibuprofen are available. The choice of drug and the dosage depend on the age and weight of the child.
Ibuprofen belongs to the group of non-steroidal anti-inflammatory drugs (NSAIDs). Ibuprofen has an antipyretic, analgesic and anti-inflammatory effect. The drug is approved for children over 3 months of age or over 6 kg in weight.
The dosage in children should be adjusted to the weight of the child. If there is any doubt about dosage or usage, consult your pediatrician. Ibuprofen for children is available in tablet form as well as in juice, powder form for dissolving or as suppositories.
Ibuprofen should not be given if the child has a known allergy or severe impairment of kidney or liver function. Paracetamol is the medicine of choice for children to treat fever and pain. It belongs to the group of non-steroidal anti-inflammatory drugs (NSAIDs).
The drug is approved for children weighing 3 kg or more. Paracetamol must not be used in premature babies and newborns due to the immature liver. Paracetamol reduces fever and pain.
Unlike ibuprofen, it has no anti-inflammatory component. The dosage of paracetamol must also be adapted to the body weight of the child. Overdoses of paracetamol must be avoided at all costs.
The child’s liver in particular quickly reaches its capacity to break down the active substance. The consequences of overdose are severe liver damage and the destruction of liver cells. For this reason, the paediatrician should be consulted prior to the first administration of paracetamol.A toxic dose is reached at 150 grams per kilogram body weight.
