title: Caring for critically ill patients with ebola virus disease. Perspectives from West Africa.
abstract: The largest ever Ebola virus disease outbreak is ravaging West Africa. The constellation of little public health infrastructure, low levels of health literacy, limited acute care and infection prevention and control resources, densely populated areas, and a highly transmissible and lethal viral infection have led to thousands of confirmed, probable, or suspected cases thus far. Ebola virus disease is characterized by a febrile severe illness with profound gastrointestinal manifestations and is complicated by intravascular volume depletion, shock, profound electrolyte abnormalities, and organ dysfunction. Despite no proven Ebola virus-specific medical therapies, the potential effect of supportive care is great for a condition with high baseline mortality and one usually occurring in resource-constrained settings. With more personnel, basic monitoring, and supportive treatment, many of the sickest patients with Ebola virus disease do not need to die. Ebola virus disease represents an illness ready for a paradigm shift in care delivery and outcomes, and the profession of critical care medicine can and should be instrumental in helping this happen.
authors.affiliation: 1 University of Toronto, Toronto, Ontario, Canada.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Fowler
authors.forename: Thomas
authors.initials: T
authors.lastname: Fletcher
authors.forename: William A
authors.initials: WA
authors.lastname: Fischer
authors.forename: Francois
authors.initials: F
authors.lastname: Lamontagne
authors.forename: Shevin
authors.initials: S
authors.lastname: Jacob
authors.forename: David
authors.initials: D
authors.lastname: Brett-Major
authors.forename: James V
authors.initials: JV
authors.lastname: Lawler
authors.forename: Frederique A
authors.initials: FA
authors.lastname: Jacquerioz
authors.forename: Catherine
authors.initials: C
authors.lastname: Houlihan
authors.forename: Tim
authors.initials: T
authors.lastname: O'Dempsey
authors.forename: Mauricio
authors.initials: M
authors.lastname: Ferri
authors.forename: Takuya
authors.initials: T
authors.lastname: Adachi
authors.forename: Marie-Claire
authors.initials: MC
authors.lastname: Lamah
authors.forename: Elhadj Ibrahima
authors.initials: EI
authors.lastname: Bah
authors.forename: Thierry
authors.initials: T
authors.lastname: Mayet
authors.forename: John
authors.initials: J
authors.lastname: Schieffelin
authors.forename: Susan L
authors.initials: SL
authors.lastname: McLellan
authors.forename: Mikiko
authors.initials: M
authors.lastname: Senga
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Kato
authors.forename: Christophe
authors.initials: C
authors.lastname: Clement
authors.forename: Simon
authors.initials: S
authors.lastname: Mardel
authors.forename: Rosa Constanza
authors.initials: RC
authors.lastname: Vallenas Bejar De Villar
authors.forename: Nahoko
authors.initials: N
authors.lastname: Shindo
authors.forename: Daniel
authors.initials: D
authors.lastname: Bausch
mesh_terms: D000354:Africa, Western / Q000453:epidemiology; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness; D004196:Disease Outbreaks / Q000706:statistics & numerical data; D019142:Hemorrhagic Fever, Ebola / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D010166:Palliative Care / Q000379:methods; D005791:Patient Care / Q000379:methods*
keywords: Africa; Ebola; critical care; outbreak; viral hemorrhagic fever