The Critically Ill Patient with Ebola Virus Disease

• The current outbreak of Ebola Virus Disease (EVD) is the largest ever recorded and has been declared "a public health emergency of international concern" by the WHO.
• Pearls regarding critically ill patients within the current EVD outbreak include:
  • Clinical Features
    • Tachycardia, tachypnea, oliguria, and alterations in mental status are common and generally seen about 7-12 days after symptom onset.
    • Shock is often due to profound hypovolemia from GI losses.
    • Hemorrhage is a late finding and most often manifests as lower GIB.
  • Labs
    • Common lab abnormalities include hypokalemia, hypocalcemia, hypoalbuminemia, and lactic acidosis.
  • Treatment
    • The mainstay of treatment is aggressive fluid resuscitation and electrolyte repletion (especially potassium).
    • Blood products can be administered for those with coagulopathy and hemorrhage.
    • Empiric antibiotics and antimalarial medications should be considered while awaiting confirmatory testing for EVD.

References

Fowler RA, et al. Caring for Critically Ill Patients with Ebola Virus Disease. Am J Resp Crit Care Med 2014; 190:733-37.