Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về y học đề tài: Clinical review: Severe malaria. | Available online http content 7 4 315 Review Clinical review Severe malaria Andrej Trampuz1 Matjaz Jereb2 Igor Muzlovic3 and Rajesh M Prabhu4 1 Research Fellow Division of Infectious Diseases Department of Internal Medicine Mayo Clinic Rochester Minnesota USA 2Staff Physician Intensive care unit Department of Infectious Diseases University Medical Centre Ljubljana Slovenia 3Head Intensive care unit Department of Infectious Diseases University Medical Centre Ljubljana Slovenia 4Instructor in Medicine Division of Infectious Diseases Department of Internal Medicine Mayo Clinic Rochester Minnesota USA Correspondence Andrej Trampuz andrejtrampuz@ Published online 14 April 2003 Critical Care 2003 7 315-323 DOI cc2183 This article is online at http content 7 4 315 2003 BioMed Central Ltd Print ISSN 1364-8535 Online ISSN 1466-609X Abstract Malaria represents a medical emergency because it may rapidly progress to complications and death without prompt and appropriate treatment. Severe malaria is almost exclusively caused by Plasmodium falciparum. The incidence of imported malaria is increasing and the case fatality rate remains high despite progress in intensive care and antimalarial treatment. Clinical deterioration usually appears 3-7 days after onset of fever. Complications involve the nervous respiratory renal and or hematopoietic systems. Metabolic acidosis and hypoglycemia are common systemic complications. Intravenous quinine and quinidine are the most widely used drugs in the initial treatment of severe falciparum malaria whereas artemisinin derivatives are currently recommended for quinine-resistant cases. As soon as the patient is clinically stable and able to swallow oral treatment should be given. The intravascular volume should be maintained at the lowest level sufficient for adequate systemic perfusion to prevent development of acute respiratory distress syndrome. Renal replacement therapy should be initiated early. .
