[Probable effect of hemofiltration on hemodynamics and tissue oxygenation in shock secondary to severe malaria].
The authors report a case of severe Plasmodium falciparum malaria in a French Guyana endemic area with secondary myocardial dysfunction treated by usual symptomatic therapy and continuous veno-venous haemofiltration (CVVH). Haemodynamic investigations revealed hyperkinetic shock and oxygen supply dependence. Haemodynamic remained critical under conventional therapy and CVVH was introduced. Haemodynamic parameters improved rapidly with reduced oxygen debt. In the absence of associated bacterial, viral and fungal infections, the systemic inflammatory response syndrome with shock and impairment of consciousness seems to be linked to severe Plasmodium falciparum malaria. The benefits and the probable mechanisms of action of CVVH are discussed.
Hommel
D
D
Service de Réanimation Polyvalente, Centre Hospitalier Genéral de Cayenne, Guyane Française.
Michard
F
F
Bollandard
F
F
Hulin
A
A
D000293:Adolescent; D017809:Fatal Outcome; D005260:Female; D006439:Hemodynamics; D006440:Hemofiltration / Q000009:adverse effects*; D006801:Humans; D016778:Malaria, Falciparum / Q000150:complications* / Q000628:therapy; D009102:Multiple Organ Failure / Q000209:etiology / Q000378:metabolism; D009449:Neurocirculatory Asthenia / Q000209:etiology* / Q000378:metabolism; D010100:Oxygen / Q000378:metabolism*; D012770:Shock, Cardiogenic / Q000209:etiology* / Q000378:metabolism; D014018:Tissue Distribution
D010100:Oxygen
Rôle probable de l'hémofiltration sur l'hémodynamique et l'oxygénation tissulaire lors d'un état de choc au décours d'un paludisme grave.