TY  - CHAP
M1  - Book, Section
TI  - Chapter 58. Severe Malaria
A1  - Warrell, David A.
A2  - Hall, Jesse B.
A2  - Schmidt, Gregory A.
A2  - Wood, Lawrence D.H.
PY  - 2005
T2  - Principles of Critical Care, 3e
AB  - Consider  the  diagnosis  of  malaria  in  any  acutely  febrile  patient  with  a  history  of  recent  travel  to  a  malarious  area  or  who  might  have  been  infected  through  blood  transfusion,  needlestick,  or  other  nosocomial  parenteral  exposure.Transfer  severely  ill  patients  to  an  ICU  and  make  a  rapid  clinical  assessment,  including  spot  measurement  of  blood  glucose.If  the  diagnosis  of  severe  falciparum  malaria  is  proved  or  suspected,  initiate  antimalarial  chemotherapy  using  optimal  doses  of  an  appropriate  agent  (licensed  quinine  or  quinidine  or  an  artemisinin  derivative  such  as  artesunate  on  a  named-patient  basis)  administered  intravenously,  using  a  loading  dose.  Monitor  the  clinical  and  parasitologic  responses.Prevent,  or  detect  early  and  treat,  the  numerous  complications  (especially  generalized  convulsions,  hypoglycemia,  hyperpyrexia,  and  secondary  bacterial  infections).Ensure  correct  fluid,  electrolyte,  and  acid-base  balance.  Control  fluid  replacement  to  prevent  circulatory  overload  and  pulmonary  edema.  Anticipate  renal  and  respiratory  failure.Expert  nursing  care  of  the  unconscious  patient  is  essential.Avoid  the  use  of  potentially  harmful  ancillary  treatments  of  unproven  benefit,  such  as  corticosteroids,  heparin,  and  epinephrine.  
SN  - 
PB  - The McGraw-Hill Companies
CY  - New York, NY
Y2  - 2021/03/04
UR  - accessanesthesiology.mhmedical.com/content.aspx?aid=2291949
ER  -