Intravenous fluids
If your child has difficulty eating or drinking due to the illness, intravenous fluids may be beneficial to treat Kawasaki disease. These fluids can maintain hydration and electrolyte balance for children. If fluid intake is inadequate, Kawasaki disease is associated with symptoms such as irritability, fever, and decreased appetite.
Intravenous fluids may be administered when your child experiences persistent fever and other symptoms during the acute phase of the disease to ensure proper hydration. This involves using an intravenous (IV) line that will allow the administration of fluids directly into a vein. The specific amount and type given will depend on the overall clinical condition, age, and weight of the child. Your healthcare provider will determine the appropriate fluid regimen to prevent dehydration and maintain fluid balance.
Rest and recovery
If your child has Kawasaki disease, they may be sent home from the hospital on a low dose of aspirin to take by mouth every day for 6 to 8 weeks, according to healthychildren.org. It’s common for your child to feel extra tired or “off” for several weeks after hospital discharge and as they recover. But rest is essential for your child, which will speed up the recovery.
However, if your child develops any of the other symptoms of Kawasaki disease or a fever, call your doctor right away. There will be further evaluation if your child needs to return to the hospital. Moreover, adequate sleep and emotional support can strengthen rest and recovery as an effective treatment for Kawasaki disease. Create a calm and safe environment for your child in your home where they can comfortably rest well. But don’t forget to offer them emotional support, especially when they were recently discharged from the hospital.
Anti-inflammatory medications
Anti-inflammatory medications such as Acetlysalicylid Acid (ASA) or aspirin can effectively treat Kawasaki disease. Aspirin’s mechanism of action depends on the dosage. To obtain anti-inflammatory effect, medium-high doses are usually given, while low doses inhibit platelet aggregation.
According to a study published by the National Library of Medicine, aspirin or ASA is approved for all patients with Kawasaki disease since it has been used to treat the condition for many years. The American Heart Association and Japanese Society of Pediatric Cardiology and Cardiac Surgery recommend medium doses (30-50 mg/kg) and high doses (80-100 mg/kg) as standard treatment during the acute febrile phase.
Pain management
Acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) are effective medications for treating Kawasaki disease by managing symptoms such as discomfort and fever. NSAIDS such as naproxen and or ibuprofen can reduce inflammation and fever in the condition. They help alleviate symptoms by having anti-inflammatory and pain-relieving properties.
However, some healthcare professionals don’t suggest using NSAIDs when coronary artery inflammation is most prominent during the acute phase. On the other hand, acetaminophen is often used to relieve pain and reduce fever in children with the disease. It can provide symptomatic relief and is effective in lowering body temperature.
Coronary artery monitoring
While this may not be a direct treatment for Kawasaki disease, it’s still an important aspect of its management. It’s essential to monitor the coronary arteries to initiate appropriate interventions to minimize the risk of complications and to detect any abnormalities early on.
For the management of coronary artery aneurysms, the Cardiologist should be contacted if an echocardiogram shows a sign of coronary artery aneurysms. Your child will need long-term aspirin therapy, according to the NHS Foundation Trust. Your child should receive an annual influenza vaccine if they’re taking long-term salicylates. Moreover, patients should be considered for the varicella zoster virus vaccine if they require long-term aspirin due to CCA.
Intravenous immunoglobulin (IVIG)
Intravenous immunoglobulin (IVIG) is considered to be the cornerstone of therapy for Kawasaki disease. Derived from pooled human blood plasma, it’s a solution that contains a high concentration of bodies. In terms of administration, IVIG is usually given as a high-dose and single infusion over a period of several hours through a vein (intravenously). The exact duration and dosage are determined by the disease’s severity and the child’s age and weight.
In terms of timing, IVIG is most effective when administered within the first ten days of the illness, specifically within the first seven days. IVIG with early treatment is associated with a lower risk of developing abnormalities in the coronary artery. While the exact mechanism of IVIG isn’t fully understood, studies show that it reduces inflammation, modulates the immune system, and inhibits certain pro-inflammatory substances and their production.
Fever management
Fever can be quite high and persistent because it’s a common symptom of Kawasaki disease. Applying effective fever management to your child will aim to reduce the risk of complications, promote your child’s well-being, and alleviate discomfort. You can start by using acetaminophen to help reduce and relieve your child’s fever. It comes in several forms, such as suppositories, liquids, and chewable tablets.
Moreover, you can apply cool sponge baths to your child, especially with lukewarm water. This can help lower body temperature, which will uphold efficient fever management. It’s important to avoid using alcohol-based solutions or cold water. Encourage your child to drink plenty of fluids in order to maintain hydration and prevent dehydration. Lastly, please dress your child in breathable and lightweight clothing and keep the room temperature comfortable to maintain their body temperature.
Cardiac interventions
In cases where stenosis and aneurysms develop, cardiac interventions may be necessary to treat the disease. Some common cardiac interventions you can choose are angioplasty, stent placement, thrombectomy, and bypass surgery. Angioplasty is a procedure to block or open narrowed coronary arteries with the use of a catheter with a balloon at its tip. The balloon is inflated to widen the artery or compress the plaque for blood flow to improve while the catheter is threaded into the narrowed area.
Stent placement helps the narrowed artery by keeping it open by inserting a small mesh tube. The stent supports the artery and prevents it from re-narrowing since the stent acts as a scaffold. You may also choose thrombectomy, as it allows the removal of blood clots (thrombi) from the coronary arteries. To physically restore blood flow and remove the lump in the affected artery involves the use of specialized tools such as aspiration devices or catheters. Lastly, bypass surgery may be rare but creates a new pathway for blood to bypass the affected coronary artery using grafts.
Corticosteroids
These types of medicine contain hormones, which can also be an effective treatment for Kawasaki disease. These powerful chemicals have a wide range of effects on the body. According to NHS UK, if IVIG isn’t effective for your child or if they have a high risk of heart problems, these may be recommended.
Healthcare professionals based on the severity of the disease and individual patient factors. Aside from the ineffective use of IVIG, if there’s a recurrence of fever after an initial response, they’re administered after the second dose or failure of IVIG. Corticosteroids may be given intravenously (through a vein) or orally (as pills or liquid). Taking these types of medicine may also lower the risk of coronary artery abnormalities and other ongoing cases of inflammation.
