title: Fluid resuscitation in Ebola Virus Disease: A comparison of peripheral and central venous accesses.
abstract: BACKGROUND
  Ebola Virus Disease (EVD) causes severe diarrhoea and vomiting, leading to dehydration and electrolyte abnormalities. Treatment remains supportive and often requires intravenous (IV) access. IV catheters are difficult to insert and maintain in this context. Our primary objective was to compare peripheral venous catheters (PVCs) and central venous catheters (CVCs) for volume resuscitation in patients with EVD.
  
  
  METHODS
  We performed a prospective observational study between January and March 2015 at the Conakry Healthcare Workers Ebola Treatment Unit (ETU). The primary judgement criterion was the ratio of the daily infused volume of fluids to the prescribed volume (DIV/PV).
  
  
  RESULTS
  Fourteen patients were admitted. Twenty-eight PVCs and 8 CVCs were inserted. CVCs had a longer survival time (96 ± 34 hours versus 33.5 ± 21 hours, P<0.001). The mean DIV/PV was higher for the CVCs (0.95±0.08 versus 0.7 ± 0.27, P<0.001), as well as the number of days with full administration of prescribed IV fluids (71.2% versus 34.1%, P=0.002).
  
  
  CONCLUSIONS
  Inserting CVCs is a safe and reliable way of obtaining IV access in ETUs, provided adequately trained personnel are available. CVCs optimize fluid infusion compared to PVCs. Further studies comparing fluid management strategies in EVD are necessary.
authors.affiliation: Anaesthesiology and Critical Care, Sainte-Anne Military Teaching Hospital, 83800 Toulon, France; Healthcare Workers Ebola Treatment Unit, Conakry, Guinea. Electronic address: jean.cotte@gmail.com.
authors.forename: Jean
authors.initials: J
authors.lastname: Cotte
authors.affiliation: Healthcare Workers Ebola Treatment Unit, Conakry, Guinea; Anaesthesiology and Critical Care, Laveran Military Teaching Hospital, 13013 Marseille, France. Electronic address: pierre-yves.cordier@laposte.net.
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Cordier
authors.affiliation: Anaesthesiology and Critical Care, Sainte-Anne Military Teaching Hospital, 83800 Toulon, France; Healthcare Workers Ebola Treatment Unit, Conakry, Guinea. Electronic address: bordes.julien@neuf.fr.
authors.forename: Julien
authors.initials: J
authors.lastname: Bordes
authors.affiliation: Healthcare Workers Ebola Treatment Unit, Conakry, Guinea; Laboratory, Sainte-Anne Military Teaching Hospital, 83800 Toulon, France. Electronic address: janvierfred@hotmail.com.
authors.forename: Frederic
authors.initials: F
authors.lastname: Janvier
authors.affiliation: Anaesthesiology and Critical Care, Sainte-Anne Military Teaching Hospital, 83800 Toulon, France. Electronic address: pierre.esnault@gmail.com.
authors.forename: Pierre
authors.initials: P
authors.lastname: Esnault
authors.affiliation: Anaesthesiology and Critical Care, Sainte-Anne Military Teaching Hospital, 83800 Toulon, France. Electronic address: kaiserenmission@gmail.com.
authors.forename: Eric
authors.initials: E
authors.lastname: Kaiser
authors.affiliation: Anaesthesiology and Critical Care, Sainte-Anne Military Teaching Hospital, 83800 Toulon, France. Electronic address: eric.meaudre@club-internet.fr.
authors.forename: Eric
authors.initials: E
authors.lastname: Meaudre
mesh_terms: D000328:Adult; D000368:Aged; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods*; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000379:methods*; D057785:Catheters / Q000009:adverse effects; D062905:Central Venous Catheters / Q000009:adverse effects; D005260:Female; D005440:Fluid Therapy / Q000009:adverse effects / Q000379:methods*; D019142:Hemorrhagic Fever, Ebola / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012151:Resuscitation; D016019:Survival Analysis
keywords: Central catheter; Ebola; Fluid resuscitation