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The Critically Ill Patient with Ebola Virus Disease
- The current outbreak of Ebola Virus Disease (EVD) is the largest ever recorded and has been declared "a public health emergency of international concern" by the WHO.
- Pearls regarding critically ill patients within the current EVD outbreak include:
- Clinical Features
- Tachycardia, tachypnea, oliguria, and alterations in mental status are common and generally seen about 7-12 days after symptom onset.
- Shock is often due to profound hypovolemia from GI losses.
- Hemorrhage is a late finding and most often manifests as lower GIB.
- Labs
- Common lab abnormalities include hypokalemia, hypocalcemia, hypoalbuminemia, and lactic acidosis.
- Treatment
- The mainstay of treatment is aggressive fluid resuscitation and electrolyte repletion (especially potassium).
- Blood products can be administered for those with coagulopathy and hemorrhage.
- Empiric antibiotics and antimalarial medications should be considered while awaiting confirmatory testing for EVD.
- Clinical Features
References
Fowler RA, et al. Caring for Critically Ill Patients with Ebola Virus Disease. Am J Resp Crit Care Med 2014; 190:733-37.