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Caring for Critically Ill Patients with Ebola Virus Disease: Perspectives from West Africa.
Am J Respir Crit Care Med. 2014 Aug 28;
Authors: Fowler RA, Fletcher T, Fischer Ii WA, Lamontagne F, Jacob S, Brett-Major D, Lawler JV, Jacquerioz FA, Houlihan C, O'Dempsey T, Ferri M, Adachi T, Lamah MC, Bah EI, Mayet T, Schieffelin J, McLellan SL, Senga M, Kato Y, Clement C, Mardel S, Vallenas Bejar De Villar RC, Shindo N, Bausch D
Abstract
The largest ever Ebola virus disease outbreak is ravaging West Africa. The constellation of little public health infrastructure, low levels of health literacy, limited acute care and infection prevention and control resources, densely populated areas and a highly transmissible, lethal viral infection, have led to over 2000 confirmed, probable or suspected cases and, thus far, more than 1000 deaths. Ebola virus disease is characterized by a febrile severe illness, with profound gastrointestinal manifestations, and is complicated by intravascular volume depletion, shock, profound electrolyte abnormalities and organ dysfunction. Despite no proven Ebola virus-specific medical therapies, the potential effect of supportive care is great for a condition with high baseline mortality and one usually occurring in resource-constrained settings. With more personnel, basic monitoring and supportive treatment, many of the sickest patients with Ebola virus disease do not need to die. Ebola virus disease represents an illness ready for a paradigm shift in care delivery and outcomes, and the profession of critical care medicine can and should be instrumental in helping this happen.
PMID: 25166884 [PubMed - as supplied by publisher]