Exchange Transfusion for Fulminant Plasmodium Falciparum Infection

Moorkens, Greta; Zachée, P B; Coolen, L J; Lauwers, L. F.; Demey, Hendrik E.; Vanpellicom, J A; Daelemans, R.; Lins, RM

doi:10.1177/039139889101400213

Cited by 4 publications

(1 citation statement)

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“…On the other hand, ET is associated with several dangers: non-cardiogenic pulmonary oedema by fluid overload, hypotension by rapid exfusion, and transmission of infectious diseases such as HIV infection or hepatitis. About 100 case studies have been published, the majority with successful or even spectacular outcomes (Gyr et al 1974;Kurathong et al 1979;Roncoroni & Martino 1979;Nielsen et al 1979;Yarrish et al 1982;Kramer et al 1983;Files et al 1984;Hall et al 1985;Chiodini et al 1985;Carpentier et al 1986;Manquat et al 1986;Schunkert & Gladziwa 1986;Lataste et al 1987;Rouvier et al 1988;Rudnitsky et al 1987;Matsuura & Chou 1988;Heim et al 1988;Pats et al 1989;Miller et al 1989;Le Camus et al 1989;Lelarge et al 1989;Bernardin et al 1989;Bach et al 1989;Elder et al 1990;Saddler et al 1990;Phillips et al 1990;Smit et al 1990;Malin et al 1990;Looareesuwan et al 1990;Salord et al 1991a;Srichaikul et al 1993;Shwe & Myint 1990;Wernli et al 1991;Graber et al 1991;Moorkens et al 1991;Wong et al 1992;Nehta et al 1994;McCoslin et al 19...…”

Section: Introductionmentioning

confidence: 99%

Exchange blood transfusion in severe falciparum malaria: retrospective evaluation of 61 patients treated with, compared to 63 patients treated without, exchange transfusion

Burchard¹,

Kröger²,

Knobloch³

et al. 1997

Tropical Med Int Health

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SummaryThe rationale for exchange blood transfusion (ET) in severe falciparum malaria is threefold: reduction of parasitaemia, reduction of presumptive 'toxic' factors, and improvement of the rheological quality of the blood. We evaluated the records of 61 patients treated with ET to describe the present status of malaria treatment in Germany, Austria and Switzerland and to assess the efficacy of ET. Clinical data of 61 patients treated with ET were compared to data of 63 patients treated in 2 hospitals where ETs were generally not performed. We found that exchange transfusion is applied according to the clinician's subjective impression rather than strict guidelines. Logistic regression analysis adjusting for the differences in clinical parameters between patients treated with or without ET did not identify treatment as a prognostic indicator (odds ratio for relative risk of death with ET: 1.3; 95% CI: 0.4-4.9). Exchange transfusion did not significantly improve the unfavourable prognosis in cases of severe falciparum malaria. However, failure to reach statistical significance may be due to the retrospective design of the study and therefore non-systematic approach.keywords malaria, Plasmodium falciparum, treatment, exchange blood transfusion correspondence Dr Gerd-Dieter Burchard, Bernhard

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