POLIOMYELITIS

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Abstract
In poliomyelitis, the entire nervous system may be involved with dysfunction of many body organs. Spinal poliomyelitis may be complicated by cardiac involvement, thrombophlebitis, renal calculi and pulmonary disturbances and each of these disturbances must be specifically handled to obtain the best therapeutic results. When the upper spinal cord is involved, there is impairment of the muscles of respiration and there is need for some type of respiratory aid such as the tank respirator, the cuirass respirator, or the rocking bed. Involvement of the lower cranial nerves results in dysphagia and obstruction of the airway. The latter must be kept open by postural drainage, mechanical suction or tracheotomy. If a tracheotomy is done it is imperative to use as large a tube as possible in order to obtain an adequate airflow. Bulbar poliomyelitis may also involve the respiratory and vasomotor centers and produce inadequate ventilation. Involvement of the pons may result in transient trismus and interference with removal of secretions. Involvement of the hypothalamus can produce hyperthermia, gastric hemorrhage, or gastric distention. These" complications must be anticipated and treated properly. Because of the respiratory disturbances in poliomyelitis, there occur frequent changes in the acid-base balance. These must be checked daily and corrections made for any disturbances noted.

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