title: Preparing for renal replacement therapy in patients with the Ebola virus disease.
abstract: The Ebola virus disease (EVD) is a serious illness characterized by fever, severe vomiting and diarrhea, and, in severe cases, multi-organ failure requiring mechanical ventilation and renal replacement therapy. The current outbreak has centered in West Africa and affected over 15,000 individuals. EVD is transmitted by direct contact with blood or other infectious bodily fluid, and as such, numerous heath care workers caring for patients with EVD have become infected. During the current outbreak, a number of patients have received advanced supportive care for EVD in Europe and North America and therefore survived. Now, many hospitals in Europe and North America are planning to accept care for patients with EVD. In this review, we discussed the key issues related to the planning and delivery of advanced supportive care in patients with EVD with a focus on the factors necessary to provide renal replacement therapy (RRT). Since success in the treatment of patients with EVD rests on both patient outcome and prevention of transmission of disease to health care workers, we extensively discussed the modes of Ebola virus transmission and recommended protocols to protect health care workers. Experience now indicates that with appropriate planning and protocols, it is possible to successfully treat EVD patients with advanced supportive care (mechanical ventilation and RRT) while avoiding transmission to health care providers. Video Journal Club "Cappuccino with Claudio Ronco" at http://www.karger.com/?doi=371530.
authors: University of Colorado Denver and VA Medical Center, Renal Division, Denver, Colo., USA.
authors: Sarah
authors: S
authors: Faubel
authors: Harold
authors: H
authors: Franch
authors: Anitha
authors: A
authors: Vijayan
authors: Michelle A
authors: MA
authors: Barron
authors: Michael
authors: M
authors: Heung
authors: Kathleen D
authors: KD
authors: Liu
authors: Jay L
authors: JL
authors: Koyner
authors: Michael J
authors: MJ
authors: Conner
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D000349:Africa / Q000453:epidemiology; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects; D001826:Body Fluids / Q000821:virology; D003264:Containment of Biohazards / Q000295:instrumentation / Q000379:methods*; D000075202:Contraindications; D003422:Critical Care / Q000379:methods*; D003695:Delivery of Health Care; D019049:Developed Countries; D003937:Diagnosis, Differential; D004196:Disease Outbreaks / Q000517:prevention & control; D029043:Ebolavirus / Q000302:isolation & purification / Q000472:pathogenicity; D004866:Equipment Contamination; D019142:Hemorrhagic Fever, Ebola / Q000150:complications* / Q000517:prevention & control / Q000628:therapy / Q000635:transmission; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control*; D007683:Kidney Tubular Necrosis, Acute / Q000209:etiology; D008403:Mass Screening; D010348:Patient Care Team / Q000941:ethics; D010356:Patient Isolation / Q000295:instrumentation / Q000379:methods; D017410:Practice Guidelines as Topic; D017582:Renal Replacement Therapy / Q000295:instrumentation / Q000379:methods*; D012121:Respiration, Artificial; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology; D014195:Travel; D014883:Water-Electrolyte Imbalance / Q000209:etiology / Q000628:therapy
chemical_list: D000925:Anticoagulants