Ebola medical therapy: Difference between revisions

Jump to navigation Jump to search
No edit summary
Line 7: Line 7:


==Medical Therapy==
==Medical Therapy==
There are no targeted antiviral therapies currently in use. Supportive care is the mainstay of medical management. where hemodynamic and respiratory support are the two most important interventions.<ref name=Emergency Physicians Review>{{cite journal| author=| title=Ebola virus outbreak 2014: clinical review for emergency physicians | journal=Annals of Emergency Medicine | year= 2014| volume= | issue= | pages= | pmid= | doi= | pmc= | url=http://www.sciencedirect.com/science/article/pii/S0196064414013961 }} </ref> Administration of whole blood and plasma products from convalescent patients using standard procedures have been administered empirically with promising results and is currently recommended as epirical treatment during outbreaks by the World Health Organization (WHO).<ref name=WHO>{{cite journal| author=| title=Use of convalescent whole blood or plasma collected from patients recovered from Ebola virus disease for transfusion, as an empirical treatment during outbreaks|  | year= 2014 | volume=  | issue=  | pages=  |  | doi=| pmc= | url=http://apps.who.int/iris/bitstream/10665/135591/1/WHO_HIS_SDS_2014.8_eng.pdf }} </ref>  
There are no targeted antiviral therapies currently in use. Supportive care is the mainstay of medical management. where hemodynamic and respiratory support are the two most important interventions.<ref name=Emergency Physicians Review>{{cite journal| author=| title=Ebola virus outbreak 2014: clinical review for emergency physicians | journal=Annals of Emergency Medicine | year= 2014| volume= | issue= | pages= | pmid= | doi= | pmc= | url=http://www.sciencedirect.com/science/article/pii/S0196064414013961 }} </ref> Administration of whole blood and plasma products from convalescent patients using standard procedures have been administered empirically with promising results and is currently recommended as empirical treatment during outbreaks by the World Health Organization (WHO).<ref name=WHO>{{cite journal| author=| title=Use of convalescent whole blood or plasma collected from patients recovered from Ebola virus disease for transfusion, as an empirical treatment during outbreaks|  | year= 2014 | volume=  | issue=  | pages=  |  | doi=| pmc= | url=http://apps.who.int/iris/bitstream/10665/135591/1/WHO_HIS_SDS_2014.8_eng.pdf }} </ref>  
===Bleeding===
===Bleeding===
*Repletion of [[coagulation factors]] with [[fresh frozen plasma]] (FFP) if available, and [[transfusion|transfuse]] with packed red blood cells and platelets may be required. Invasive procedures should be avoided to prevent further bleeding.
*Repletion of [[coagulation factors]] with [[fresh frozen plasma]] (FFP) if available, and [[transfusion|transfuse]] with packed red blood cells and platelets may be required. Invasive procedures should be avoided to prevent further bleeding.

Revision as of 20:51, 27 October 2014

Ebola Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Ebola from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Algorithm for the Evaluation of the Returned Traveler

Emergency Department Evaluation

Case Definition

History and Symptoms

Physical Examination

Laboratory Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Hospital Preparedness

Checklists

Air Medical Transport

Monitoring and Movement Following Exposure

Primary Prevention

Future or Investigational Therapies

Postmortem Care

Postmortem Care

Case Studies

Case #1

Ebola medical therapy On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Ebola medical therapy

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Ebola medical therapy

CDC on Ebola medical therapy

Ebola medical therapy in the news

Blogs on Ebola medical therapy

Directions to Hospitals Treating ebola

Risk calculators and risk factors for Ebola medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Guillermo Rodriguez Nava, M.D. [2]

Overview

No specific antiviral drug has demonstrated effectiveness against Ebola infection. Management is primarily supportive and symptomatic. The following basic interventions, when used early, may improve the chances of survival: administration of intravenous fluids and correction of electrolyte abnormalities, maintenance of stable vital signs, and treatment against other co-infections or super-infections by antimicrobial agents. It is common practice to administer prophylactic broad-spectum antimicrobial agents, such as antibiotics and antimalarial agents, due to the high risk of co-infection or super-infection.

Medical Therapy

There are no targeted antiviral therapies currently in use. Supportive care is the mainstay of medical management. where hemodynamic and respiratory support are the two most important interventions. Administration of whole blood and plasma products from convalescent patients using standard procedures have been administered empirically with promising results and is currently recommended as empirical treatment during outbreaks by the World Health Organization (WHO).[1]

Bleeding

Dehydration and Shock

  • Patients with Ebola virus disease should be considered high-risk for development of shock.
  • Intravenous fluids should be aggressively administered with careful consideration of electrolyte imbalances.
  • Hypokalemia and hypocalcemia are common and repletion of potassium levels and calcium may be necessary.
  • A combination of intravenous fluids, vasopressors, and blood products may be necessary as needed.

Hypoxia

Supplemental oxygen, including intubation and mechanical ventilation, may be necessary for patients with severe dyspnea, pulmonary edema, severe hemorrhage, and acute respiratory distress syndrome (ARDS).

Superimposed Infections

Antimicrobial agents are necessary to treat infectious complications of Ebola virus disease.[2]

Prophylaxis Against Co-infections or Superinfections

It is common practice to administer antibiotics and antimalarial agents for patients with Ebola virus disease due to the high risk of co-infection or super-infection with Malaria and bacterial organisms.[2]

Nutritional Support

  • Although preferred, enteral nutrition may not be tolerated due to vomiting or paralytic ileus.
  • Parental nutrition should be administered to patients who cannot tolerate oral food intake.
  • Enteral nutrition should be resumed as soon as it is tolerated.

References

  1. "Use of convalescent whole blood or plasma collected from patients recovered from Ebola virus disease for transfusion, as an empirical treatment during outbreaks" (PDF). 2014.
  2. 2.0 2.1 Kreuels B, Wichmann D, Emmerich P, Schmidt-Chanasit J, de Heer G, Kluge S; et al. (2014). "A Case of Severe Ebola Virus Infection Complicated by Gram-Negative Septicemia". N Engl J Med. doi:10.1056/NEJMoa1411677. PMID 25337633.


Template:WH Template:WS