Optimizing the Intensive Care Treatment of Severe and Complicated Plasmodium falciparum Malaria in Nonimmune Patients

Chentsov, V B; Tokmalaev, A K; Кожевникова, Г М; Baranova, A M; Vdovina, Elena Tagirovna; Emerole, Karl

doi:10.1155/2020/1628270

Cited by 3 publications

(2 citation statements)

References 15 publications

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“…This case series result is consistent with the findings of the previous study [9,30]. The length of ICU stay range from 2 ~ 10 days, and all patients treated with ET-AS remained in the hospital for 3 ~ 19 days, significantly shorter than the findings reported by previous studies [30,31]. Malaria-associated acute kidney injury with severe malaria is associated with increased mortality [32].…”

Section: Discussionsupporting

confidence: 90%

Exchange transfusion combined with artesunate (ET-AS) as a safe and effective therapy in severe P. falciparum malaria: a case series

Zhang,

Chen,

Zhang

et al. 2024

BMC Infect Dis

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Background the mortality associated with severe malaria due to Plasmodiun falciparum remains high despite improvements in malaria management. Case prensentation: this case series aims to describe the efficacy and safety of the exchange transfusion combined with artesunate (ET-AS) regimen in severe P. falciparum malaria. Eight patients diagnosed with severe P. falciparum malaria were included. All patients underwent ET using the COBE Spectra system. The aimed for a post-exchange hematocrit of 30%. Half the estimated blood volume was removed and replaced using fresh frozen plasma. The regimen was well-tolerated without complications. The parasite clearance time ranged from 1 ~ 5 days. Five patients with cerebral malaria exhibited full improved consciousness within 3 days, while patient2 with hemolysis improved on day 2. Liver function improved within 1 ~ 6 days, and patient 1 and patient 6 showed improvements renal function on days 18 and 19, respectively. The length of intensive care unit stay range from 2 ~ 10 days, and all patients treated with ET-AS remained in the hospital for 3 ~ 19 days. Conclusions: these preliminary results suggest that ET-AS regimens are a safe and effective therapy for severe P. falciparum malaria and can benefit patients in clinical settings.

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Section: Discussionsupporting

confidence: 90%

Exchange transfusion combined with artesunate (ET-AS) as a safe and effective therapy in severe P. falciparum malaria: a case series

Zhang,

Chen,

Zhang

et al. 2024

BMC Infect Dis

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“…This retrospective study result is consistent with the ndings of the previous study [9,19] . The median length of ICU and hospital treatments stay is 3 days and 6 days, signi cantly shorter than the ndings reported by previous studies [19,20] . Malaria-associated acute kidney injury with severe malaria is associated with increased mortality [21] .…”

Section: Discussioncontrasting

confidence: 56%

Exchange Transfusion combined with Artesunate (ET-AS) as a safe and effective Therapy in Severe P. falciparum Malaria: A retrospective case series

Zhang,

Chen,

Zhang

et al. 2023

Preprint

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Background. The mortality associated with severe P. falciparum malaria remains high despite improvements in malaria management. This study aims to observe the efficacy and safety of the ET-AS regimen in severe P. falciparum malaria. Methods. Eight patients diagnosed with severe P. falciparum malaria were enrolled. All patients underwent ET using the COBE Spectra system. The aimed for a post-exchange hematocrit of 30%. Half the estimated blood volume was removed and replaced using fresh frozen plasma. Results. The regimen was well-tolerated without complications. The median parasite clearance time was 2.5 days. Five patients with cerebral malaria exhibited improved consciousness within 3 days. There was observed improvement in a patient presenting with hemolysis on Day 2. The median time of improved liver and renal function was 1.5 days and 10 days. The median length of intensive care unit (ICU) and hospital treatments was 3 days and 6 days. Conclusions. ET-AS improved the clinical picture and reduce the duration of hospitalization and ICU stays. These preliminary clinical data are valuable to practitioners and provide a basis for a randomized controlled trial of this therapy.

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Management of severe <i>Plasmodium falciparum</i> malaria in adults: A review of national and regional guidelines and their adherence to World Health Organization guidelines

Tokmalaev¹,

Chentsov²,

Emerole³

et al. 2023

Epidemiology and Infectious Diseases

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Background: the most prevalent and pathogenic malaria parasite associated with severe illness and death is Plasmodium falciparum. In non-endemic countries like the Russian federation, P. falciparum malaria is a relatively rare but potentially fatal disease found in travelers returning from countries with high malaria burden. Aims: this review aims to analyze the recommendations for managing severe Plasmodium falciparum malaria in different World Health Organization (WHO) malaria endemic regions and considered their adherence to the WHO guidelines. Materials and methods: we identified countries with the highest number of indigenous falciparum malaria cases from four WHO regions and search for their malaria treatment guidelines using databases. Results: intravenous artesunate is the mainstay treatment for severe falciparum malaria. Mefloquine or fansidar was not indicated in the reviewed guidelines as. Most guidelines lack a mechanism for referring patients with severe malaria, between different levels of health facilities and lack specific criteria for intensive care unit admission. Conclusions: mefloquine and artemisinin - combination products containing mefloquine should be used with caution in cerebral malaria due to neuropsychiatric and cognitive complications. Understanding how guidelines and recommendations for the clinical practice of malaria areadopted in different epidemiological settings will help to contextualize the value and validity of recommendations for treatment of severe malaria.

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Optimizing the Intensive Care Treatment of Severe and Complicated Plasmodium falciparum Malaria in Nonimmune Patients

Cited by 3 publications

References 15 publications

Exchange transfusion combined with artesunate (ET-AS) as a safe and effective therapy in severe P. falciparum malaria: a case series

Exchange transfusion combined with artesunate (ET-AS) as a safe and effective therapy in severe P. falciparum malaria: a case series

Exchange Transfusion combined with Artesunate (ET-AS) as a safe and effective Therapy in Severe P. falciparum Malaria: A retrospective case series

Management of severe <i>Plasmodium falciparum</i> malaria in adults: A review of national and regional guidelines and their adherence to World Health Organization guidelines

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