What is the supportive systemic therapy after the second day of hospitalization in Stevens-Johnson syndrome (SJS)?

Updated: Jan 17, 2019
  • Author: C Stephen Foster, MD, FACS, FACR, FAAO, FARVO; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Answer

After the second day of hospitalization, oral intake of fluids provided by nasogastric tube is often begun, so that intravenous fluids can be tapered progressively and discontinued, usually in 2 weeks.

Massive parenteral nutrition is necessary as soon as possible to replace the protein loss and to promote healing of cutaneous lesions. Intravenous insulin therapy may be required because of impaired glycoregulation.

Environmental temperature raised to 30-32°C reduces caloric loss through the skin. Fluidized air beds are recommended if a large portion of the skin on the patient's backside is involved. Heat shields and infrared lamps are used to help reduce heat loss.

Anticoagulation with heparin for the duration of hospitalization is recommended. Antacids reduce the incidence of gastric bleeding.


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