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.
References
Fowler RA, et al. Caring for Critically Ill Patients with Ebola Virus Disease. Am J Resp Crit Care Med 2014; 190:733-37.
