Optimized Supportive Care for Ebola Virus Disease
Clinical management standard operating procedures
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Clinical management standard operating procedures
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Overview
Ebola virus disease (EVD) is a life-threatening multisystem illness associated with fever and gastrointestinal (GI) symptoms that frequently leads to hypovolaemia, metabolic acidosis, hypoglycaemia, and multi-organ failure. The prolonged 2013–2016 EVD outbreak in West Africa allowed for an evolution of care such that by outbreak end many patients received individualized and optimized supportive care (oSoC), including volume resuscitation, symptom control, laboratory and bedside monitoring of glucose, electrolyte levels and organ dysfunction, as well as rapid detection and treatment of co-infections, potentially contributing to the downward trend in the case fatality rate (CFR).
However, considerable variability exists in the level of supportive care offered between Ebola treatment units (ETUs) in the same outbreak as well as across outbreaks. Building on evidence-informed guidelines created by a multidisciplinary panel of health care providers with experience in the clinical management of patients with EVD, this guidance should serve as a foundation for oSoC that should be followed to ensure both the best possible chance for survival and allow for reliable comparison of investigational therapeutic interventions as part of a randomized controlled trial. This guideline provides recommendations for the management of adults and children.
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