UMEM Educational Pearls

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.


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