Caring for Critically Ill Patients with Ebola Virus Disease Perspectives from West Africa

被引：148

作者：

Fowler, Robert A. ^{[1
]}

Fletcher, Thomas ^{[2
]}

Fischer, William A., II ^{[3
]}

Lamontagne, Francois ^{[4
]}

Jacob, Shevin ^{[5
]}

Brett-Major, David ^{[6
]}

Lawler, James V. ^{[7
]}

Jacquerioz, Frederique A. ^{[8
]}

Houlihan, Catherine ^{[11
]}

O'Dempsey, Tim ^{[2
]}

Ferri, Mauricio ^{[12
]}

Adachi, Takuya ^{[13
]}

Lamah, Marie-Claire ^{[14
]}

Bah, Elhadj Ibrahima ^{[14
]}

Mayet, Thierry ^{[15
]}

Schieffelin, John ^{[9
]}

McLellan, Susan L. ^{[9
]}

Senga, Mikiko ^{[16
]}

Kato, Yasuyuki ^{[17
,18
]}

Clement, Christophe ^{[19
]}

Mardel, Simon ^{[20
]}

De Villar, Rosa Constanza Vallenas Bejar ^{[16
]}

Shindo, Nahoko ^{[16
]}

Bausch, Daniel ^{[10
]}

机构：

[1] Univ Toronto, Toronto, ON M4N 3M5, Canada

[2] Univ Liverpool, Liverpool Sch Trop Med, Liverpool L3 5QA, Merseyside, England

[3] Univ N Carolina, Dept Med, Chapel Hill, NC USA

[4] Univ Sherbrooke, Clin Ctr Hosp, Ctr Rech, Sherbrooke, PQ, Canada

[5] Univ Washington, Dept Med, Seattle, WA USA

[6] WHO, Hlth Secur & Environm, CH-1211 Geneva, Switzerland

[7] Naval Med Res Ctr, Ft Detrick, MD USA

[8] Tulane Univ, Dept Med, Sch Publ Hlth & Trop Med, New Orleans, LA 70118 USA

[9] Tulane Univ, Sch Publ Hlth & Trop Med, Dept Clin Med & Pediat, New Orleans, LA 70118 USA

[10] Tulane Univ, Sch Publ Hlth & Trop Med, Dept Trop Med, New Orleans, LA USA

[11] London Sch Hyg & Trop Med, London WC1, England

[12] Univ Calgary, Dept Community Hlth Sci, Calgary, AB, Canada

[13] Toshima Hosp, Toshima, Japan

[14] Donka Hosp, Conakry, Guinea

[15] Ctr Hosp Dax Cote Argent, Dax, France

[16] WHO, Pandem & Epidem Dis, CH-1211 Geneva, Switzerland

[17] Natl Ctr Global Hlth & Med, Div Preparedness & Emerging Infect, Tokyo, Japan

[18] Nihon Univ, Tokyo, Japan

[19] Polyclin Bordeaux Nord Aquitaine, Bordeaux, France

[20] Univ S Manchester Hosp, Emergency Dept, Manchester M20 8LR, Lancs, England

来源：

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE | 2014年 / 190卷 / 07期

关键词：

Ebola; Africa; critical care; outbreak; viral hemorrhagic fever; TIME;

D O I：

10.1164/rccm.201408-1514CP

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

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 and lethal viral infection have led to thousands of confirmed, probable, or suspected cases thus far. 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.

引用

页码：733 / 737

页数：5

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